经皮椎间孔镜与小开窗髓核摘除术治疗腰椎间盘突出症的疗效比较  

Comparison of clinical effects of small incision fenestration and percutaneous transforaminal endoscopic spine system in the treatment of lumbar disc herniation

作　　者：王建顺[1] 张军[1] 王新虎[1] 刘夏君[1] 张国华[1] 杜伟[1] 左春光 

机构地区：[1]宝鸡市中心医院脊柱外科,陕西宝鸡721008

出　　处：《颈腰痛杂志》2016年第4期300-302,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的对比分析经皮椎间孔镜技术与小开窗髓核摘除术在腰椎间盘突出症治疗中的疗效。方法回顾性分析2012-03—2013—06手术治疗的134例腰椎间盘突出症患者，其中经皮椎间孔镜手术组63例，小开窗髓核摘除组71例。分别统计两组的手术时间、出血量、术后卧床时间、住院时间。采用疼痛视觉模拟评分（visualanaloguescale,VAS）、Oswestry功能障碍指数（Oswestry disability index，ODI）评定疗效。结果患者随访时间12～23个月，平均16．8个月。椎间孔镜组手术时间较小开窗髓核摘除组长，但手术出血量、术后卧床时间和住院时间均较开放组少。两组术后3d、3个月、12个月的VAS评分和ODI指数均较术前明显下降（P〈0．05）。结论小开窗髓核摘除和经皮椎间孔镜下髓核摘除术均可有效治疗腰椎间盘突出症，且后者手术创伤更小，术后恢复更快，并发症少，但手术学习曲线较长，并需要选择合适的适应证。Objective To compare the clinical effect of small incision fenesteation and percutaneous transforaminal endoscopic spine system in the treatment of lumbar disc herniation. Methods From March 2012 to June 2013,134 patients with lumbar disc herniation by surgical treatment were retrospectively analyzed. 63 patients were treated with pereutaneous transforaminal endoscopic spine system, 71 patients were treated with small incisiou fenestration. The operative time, amount of bleeding, postoperative bed time,duration of hospitalization were compared. The clinical therapeutic results were evaluated by visual analogue scale （VAS） assessment and oswestry disability index （ODI） curative effect standard. Results Patients were tbllowed up for 12~23 months, with an average of 16.8 months. The operation time of the small incision fenestration was shorter than percutaneous transforaminal endoscopic spine system group. But the amouut of bleeding, postoperative bed time, duration of hospitalization were less in small incision fenestration group. 2 groups of 2 days, 3 months, 12 months VAS score and ODI were significantly decreased compared with preoperation. Conclusion The small incision fenestration and percutaneous transforaminal endoscopic spine system are very good for treatment of lumbar disc herniation, the latter has less operative trauma, faster recovery after surgery, fewer complications, trot surgical learning curve is longer, and need to select the appropriate indications.

关 键 词：腰椎间盘突出症 内窥镜 微创 小切口 

分 类 号：R681.53[医药卫生—骨科学]