椎间孔镜条件下置入椎弓根钉治疗腰椎间盘突出症  

Pedicle screw for lumbar disc herniation under transforaminal endoscopy

作　　者：陈广儒 卫建民 

机构地区：[1]宝鸡市中医院骨科,陕西省宝鸡市721000

出　　处：《中国组织工程研究》2015年第35期5641-5645,共5页Chinese Journal of Tissue Engineering Research

基　　金：陕西省卫生厅计划项目(9612013Y0143)~~

摘　　要：背景:腰椎间盘突出症是椎间盘发生退行性变化后,生物化学变化引起腰部疼痛、下肢放射性疼痛的临床综合征。临床常采用经皮椎间孔镜(TESSYS)与椎间盘镜系统治疗,但其疗效具有差异性。目的:比较经皮椎间孔镜与椎间盘镜系统治疗腰椎间盘突出症的临床疗效。方法:回顾性分析134例腰椎间盘突出症患者的治疗及随访资料,根据治疗方法分为经皮椎间孔镜组(76例)和椎间盘镜系统组58例,比较两组患者的术中情况、修复后不同时间的疼痛、腰椎功能变化情况。结果与结论:1腰椎间盘突出症修复前两组患者的目测类比评分、Oswestry功能障碍指数评分比较差异不显著(P>0.05);两组患者修复后第1,3,6个月及末次随访两项评分均显著的降低(P<0.05);修复后各时间点经皮椎间孔镜组两项评分均显著的低于椎间盘镜系统组(P<0.05)。2修复前两组患者的日本矫形外科学会评分比较差异不显著(P>0.05);修复后第1,3,6个月及末次随访经皮椎间孔镜组患者的日本矫形外科学会评分显著高于椎间盘镜系统组(P<0.05)。3末次随访经皮椎间孔镜组的优良率显著高于椎间盘镜系统组(P<0.05)。4经皮椎间孔镜组患者的手术时间、切口长度显著的短于椎间盘镜系统组,两组术中出血量比较差异不显著(P>0.05)。结果表明,经皮椎间孔镜治疗腰椎间盘突出症具有创伤小,修复后患者疼痛轻微,功能恢复良好的优点。BACKGROUND：Lumbar disc herniation is a clinical syndrome of lumbar pain and radiated pain of the lower limb induced by biochemical changes after intervertebral disc degeneration. Transforaminal endoscopic spine system （TESSYS） and Yeung endoscopic spine system （YESS） are commonly used in the clinic, but their effects are different. OBJECTIVE：To compare the curative effect of TESSYS and YESS in treatment of lumbar disc herniation. METHODS：Fol ow-up data of 134 cases of lumbar disc herniation were retrospectively analyzed. They were assigned to TESSYS group （n=76） and YESS group （n=58）. Intraoperative condition, pain at various time points after repair, and lumbar function changes were compared between the two groups. RESULTS AND CONCLUSION：（1） No significant difference in Visual Analogue Scale and Oswestry Disability Index scores was detected between the two groups before repair （P〉0.05）. At 1, 3, and 6 months after repair and during final fol ow-up, above scores were significantly decreased in both groups （P〈0.05）. Above scores were significantly lower in the TESSYS group than in the YESS group at various time points after repair （P〈0.05）.nbsp;（2） No significant difference in Japanese Orthopedic Association score was found between the two groups before repair （P〉0.05）. Japanese Orthopedic Association score was greater in the TESSYS group than in the YESS group at 1, 3 and 6 months fol owing repair and during final fol ow-up （P〈0.05）. （3） The excel ent and good rate was significantly greater in the TESSYS group than in the YESS group during final fol ow-up （P〈0.05）. （4） Operation time and incision length were significantly shorter in the TESSYS group than in the YESS group. No significant difference in the amount of bleeding was detectable between the two groups （P〉0.05）. Results suggest that TESSYS for lumbar disc herniation was characterized by smal trauma, mild pain and good recovery of function.

关 键 词：植入物 脊柱植入物 经皮椎间孔镜 腰椎间盘突出症 椎间盘镜系统 临床疗效 

分 类 号：R318[医药卫生—生物医学工程]