经皮椎间孔镜腰椎间盘切除术与开窗腰椎间盘切除术治疗腰椎间盘突出症的疗效对比  

Comparison of clinical efficacy of percutaneous transforaminal endoscopic discectomy and simple discectomy in the treatment of lumbar intervertebral disc herniation

作　　者：袁超[1] 孙海燕[2] 丁超[2] 宋元进[2] 郝其全[2] 王英胜[2] 

机构地区：[1]潍坊医学院,山东潍坊261042 [2]解放军第89医院,山东潍坊261021

出　　处：《颈腰痛杂志》2016年第6期482-486,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的比较经皮椎间孔镜腰椎间盘切除术与开窗腰椎间盘切除术治疗腰椎间盘突出症(LDH)的近期临床疗效。方法回顾性分析2014-01-2015-01期间在我科接受手术治疗的单节段LDH患者80例,其中接受经皮椎间孔镜腰椎间盘切除术(PTED)患者40例,接受开窗腰椎间盘切除术患者40例.比较两种手术切口长度、手术时间、出血量、住院天数等情况。手术效果按照视觉疼痛模拟评分(visual analogue scale,VAS)、改良Mac Nab标准进行评定。结果 PTED组及开窗腰椎间盘切除术组的切口长度、出血量、住院天数比较,差异均有统计学意义(P<0.05),手术时间差异无统计学意义(P>0.05)。两组患者术后随访时间平均12个月,PTED组术前及术后各个随访点VAS评分与开窗组相比较,差异无统计学意义(P>0.05),两组术后各随访时间点腰腿痛VAS评分较术前均明显改善(P<0.05)。PTED组和开窗腰椎间盘切除术患者末次随访时按改良Macnab标准评定,优良率分别为:、92.5%和90%,组间比较差异无统计学意义(P>0.05)。结论 PTED与开窗腰椎间盘切除术治疗单节段腰椎间盘突出症均可取得满意的近期临床疗效。但PTED具有创伤小、出血少和恢复快等[8]特点,是更为理想的微创手术方法。Objective To compare the clinical efficacy of percutaneous transforaminal endoscopic diseectomy（PTED） and simple discectomy for lumbar disc herniation （LDH）. Methods The data of 80 patients with single segment LDH who were adopted by our department from January 2014 to January 2015 were retrospectively studied. All patients were divided into two groups, including 40 patients undergoing PTED and 40 patients undergoing simple discectomy respectively. The factors including the length of skin incision, operation time, amount of intraoperative bleeding, duration were compared. The visual analogue scale （VAS） and modified MacNab criteria were used to measure the clinical outcomes. Results There were significant differences in the observation factors such as the skin incision length, amount of intraoperative bleeding, duration between the two groups （P〈0.05）, without significant differences in operation time （P〉0.05）. After surgery, the patients in both two groups were followed up for 12 months on average. The postoperative back and leg pain VAS scores at each follow-up time point in both two groups were significantly improved when compared with the preoperative ones （P〈0.05）. According to the modified MacNab criteria, the excellent and good rates were 92.5% and 90% respectively in the PTED group and simple diseeetomy group in the latest follow-up, and the difference between the two groups was not statistically significant （P〉0.05）. Conclusion The clinical efficacy of both PTED and simple discectomy in the treatment of single segment LDH is satisfactory. However, PTED is a better minimally invasive surgical method with less trauma, less blood loss, early function recovery and so on.

关 键 词：经皮椎间孔镜腰椎间盘切除术 开窗腰椎间盘切除术 腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]