经皮椎间孔镜后路椎板间与侧后方椎间孔入路治疗腰5/骶1椎间盘突出症对比研究  

Clinical effects of discectomy with transforaminal endoscope cthrough interlaminar approach and transforaminal approach for L5/S1 lumbar disc herniation

作　　者：罗毅[1,2] 丁晓川 侯伟光 刘煊文 张强 

机构地区：[1]成都中医药大学临床医学院,四川成都610072 [2]成都363医院,四川成都610041

出　　处：《西部医学》2015年第6期865-867,共3页Medical Journal of West China

基　　金：四川省科技厅支撑课题(05SG022-008)

摘　　要：目的 比较经皮椎间孔镜下后路椎板间入路及侧后方椎间孔入路治疗腰5/骶1椎间盘突出症的疗效,并评估其临床应用价值.方法 将24例腰5/骶1椎间盘突出症患者随机分为后路椎板间入路12例及侧后方椎间孔入路12例,并进行0.5～2年的临床随访,以评价不同入路方式的治疗效果与临床价值.结果 24例患者平均随访时间12个月.经椎板间组较经椎间孔组患者手术时间短,术中出血量少,C臂照射次数少,差异均有统计学意义（均P＜0.05）.术后1个月和末次随访,两组患者VAS评分差异无统计学意义（P＞0.05）.Macnab评分：经椎板间组术后1个月优良率为83.3％,末次随访优良率为91.7％,经椎间孔组术后1个月优良率为91.7％,末次随访优良率为91.7％,两组间比较,差异无统计学意义（均P＞0.05）.结论 经皮椎间孔镜下后路椎板间入路是一种安全、有效、微创的治疗方案.后路椎板间入路较侧后方椎间孔入路更加简单,且可减少手术时间及透视次数,具有临床推广应用价值.Objective To explore the clinical effects of discectomy with transforaminal endoscope through interlam- inar approach and transforaminal approach for L5/S1 lumbar disc herniation. Methods 22 patients with L5/sl lumbar disc herniation were divided into groupe of the interlaminar approach and the transforaminal approach with a follow-up of 1-2 years. Results 22 cases were followed up with an average of 12 months. Compare to the transforaminal approach groupe, the interlaminar approach grpupe had shorter operative time.less blood loss and shotrer X-ray irradiation times （P〈0. 05） ;the two groups in 1 month postoperative and latest follow-up, the lumbar functional rating score, VAS score had no significant differences compared with pre-operation（P〉0.05）;In interlaminar approach group, the excellent rate was 83.3% in 1 month post-operation and 91.7% in latest follow-up. In control group, the excellent rate was 91.7M in 1 month transforaminal approach and 91. 7% in latest follow-up, there was no significant differences between the two groupes（P〉0.05）. Conclusion The discectomy with transforaminal endoscope through interlaminar approach for lumbar disc herniation is a safe, effective and minimally invasive therpy. Compare to the transforaminal approach, the interlaminar approach is more simple,and can decrease operative time and X-ray irradiation times.

关 键 词：椎间孔镜 椎板间入路 椎间孔入路 

分 类 号：R681.53[医药卫生—骨科学]