改良TESSYS椎间孔镜技术治疗腰椎间盘突出症  

Improved TESSYS intervertebral foramen mirror technology to treat lumbar disc herniation

作　　者：许益文[1] 郑勇[1] 陈明[1] 石振[1] 李彦武[1] 游景扬[1] 张柘[1] 范江荣[1] Xu Yiwen Zheng Yong Chen Ming et al(Department of Orthopaedics, Xianning Central Hospital, the First Affiliated Hospital of Hubei University of Science and Technology, Xianning Hubei, 437100, China)

机构地区：[1]咸宁市中心医院湖北科技学院第一附属医院骨科,湖北咸宁437100

出　　处：《生物骨科材料与临床研究》2017年第1期29-32,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨改良椎间孔镜技术(Transforaminal Endoscopic Spine System,TESSY)下椎间盘髓核摘除术治疗腰椎间盘突出症的临床疗效。方法自2013年10月~2014年12月我科27例腰椎间盘突出症患者采用改良TESSY技术的方法治疗,年龄43~68岁,平均51岁,其中L_(4/5)节段11例,L_5/S_1节段8例,L_(3/4)节段5例,L_(4/5)、L_5/S_1双节段3例。术前、术后随访腰椎疼痛及功能评定分别按疼痛视觉模拟评分(Visual analog score,VAS)与日本骨科协会评分(Japanese orthopaedics association,JOA)来评估。临床疗效按Mac Nab标准评估。对照组为采用常规TESSYS技术的患者32例。结果两组患者均得到随访,随访时间12~18个月,平均15.8月。VAS评分:本组术前(7.21±2.35),术后(2.43±1.82);对照组术前(7.15±2.47),术后(3.52±2.13)。JOA评分:本组术前(12.82±2.45),术后(25.81±2.14);对照组术前(12.77±2.69),术后(20.98±4.72)。两组间术前比较>0.05,术后比较<0.05。临床疗效按Mac Nab标准:本组优良率88.89%;对照组84.37%,两组间优良率比较<0.05。结论改良TESSY技术椎间孔镜下视野更宽阔,减压更彻底,术后疼痛缓解更明显。Objective To explore improvement ofintervertebral foramen interverbertebral disc excision of nucleus pulposus under the mirror technology to treat the clinical curative effect of lumbar disc herniation. Methods Since Oct 2013 to Dec 2014, there were 27 cases with lumbar disc herniation using the method of improved TESSYS technology, aged 43 to 68, an average of 51, 11 cases of L4/5 segments, 8 cases of L5/S1 segments, L3/4 segments in 5 cases, 3 cases of L4/5, L5/S1 double segments. Preoperative and postoperative follow-up of lumbar pain and functional assessment respectively according to the visual analog pain score （VAS） and the Japanese orthopaedic association scoring （JOA）. The clinical effect was evaluated by MacNab standard. The control had 32 cases which were all used the conventional TESSYS technology. Results Two groups of patients were all followed up for 12 to 18 months, average 15.8 months. The VAS score of the experimental group respectively was （7.21±2.35） pre-operation and （2.43±1.82） post-operation. It was （7.15±2.47） pre-operation and （3.52±2.13）post-operation in the control group. The JOA score of the one was （12.82±2.45） pre-operationand （25.81±2.14） post-operation. It was （12.77±2.69） pre-operation and （20.98±4.72） post-operationin the other. Preoperative comparison between the two groups （P〉0.05）, postoperative comparison （P〈0.05）. According to MacNab criteria of clinical effects, The excellent-good rate was 88.89% in the experimental group, the control group 84.37%. The rate of good-excellent was compared between the two groups （P〈0.05）. Conclusion Improved techniques TESSYS have intervertebral foramen microscopically view wider, decompressing more complete, more obvious postoperative pain relief.

关 键 词：TESSYS 椎间孔镜 腰椎间盘突出症 

分 类 号：R687.3[医药卫生—骨科学]