椎间孔镜maxMore技术治疗青少年腰椎间盘突出症  

MaxMore Technique via Transforaminal Endoscopic Spine System in the Treatment of Lumbar Disc Herniation in Adolescent Patients

作　　者：赵宏[1] 李纯志[1] 方煜[1] 刘伟[1] 程继伟[1] 幸永明[1] 

机构地区：[1]解放军第113医院骨科,宁波315040

出　　处：《中国微创外科杂志》2017年第5期432-436,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经皮椎间孔镜maxMore技术治疗青少年腰椎间盘突出症的效果。方法 2009年6月~2015年5月对69例青少年单间隙腰椎间盘突出症采用经皮椎间孔镜maxMore技术,经后外侧入路进入椎管建立工作通道,经工作通道切除突出病变的髓核。采用视觉模拟评分法(visual analogue scale,VAS)、改良Oswestry指数(Oswestry disability index,ODI)简体中文版和Nakai评分标准进行评定。结果手术时间53~146 min,平均83 min;住院时间4~15 d,平均5.7 d。术后平均随访8.9月(6~15个月)。腰痛VAS术前评分中位数7分(3~9分),显著高于术后3个月中位数2分(0~5分)(Z=-8.883,P=0.000)和术后6个月中位数2分(0~5分)(Z=-8.934,P=0.000);下肢痛VAS术前评分中位数7分(4~9分),显著高于术后3个月中位数1分(0~6分)(Z=-9.369,P=0.000)和术后6个月中位数2分(0~5分)(Z=-9.504,P=0.000)。术前ODI为(48.7±11.5)%,显著高于术后3个月(14.6±6.7)%(P=0.000)和术后6个月(15.3±5.5)%(P=0.000)。根据Nakai评分标准,术后6个月优28例,良33例,可6例,差2例,优良率88.4%(61/69)。结论经皮椎间孔镜maxMore技术治疗青少年腰椎间盘突出症创伤小,疗效满意,是治疗青少年腰椎间盘突出症的理想手术方式。Objective To analyze the outcomes of maxMore technique via transforaminal endoscopic spine system in the treatment of lumbar disc herniation in adolescent patients. Methods A total of 69 cases of single-segment lumbar disc herniation from June 2009 to May 2015 who underwent discectomy using the maxMore technique of transforaminal endoscopic spine system were included in this retrospective study. The visual analogue scale （VAS） , the simplified modified Chinese version of the Oswestry disability index （ODI） and the Nakai scores had been applied for measuring their clinical outcomes. Results All the surgeries had been performed successfully with an operation time of 53 - 146 min （mean, 83 min）. The duration of hospital stay was 4 - 15 days （mean, 5.7 days）. The mean follow-up period was 8.9 months （range, 6 -15 months）. The median osphyalgia VAS scores were 7 points （range, 3 -9 points） preoperatively, 2 points （range, 0 -5 points） at 3 months postoperatively, and 2 points （range, 0 -5 points） at 6 months postoperatively. The preoperative osphyalgia VAS scores were significantly higher than that at 3 months postoperatively （ Z = - 8. 883, P -- 0. 000） and that at 6 months postoperatively （ Z = - 8. 934, P = 0. 000）. The median preoperative melosalgia VAS scores were 7 points （range, 4 -9 points） , 1 point （range, 0 -6 points） at 3 months postoperatively, and 2 points （range, 0- 5 points） at 6 months postoperatively. The preoperative melosalgia VAS scores were significantly higher than that at 3 months postoperatively （Z = - 9. 369, P = 0. 000） and that at 6 months postoperatively （Z = -9.504, P = 0. 000）. The ODI significantly decreased from （48.7 ± 11.5 ） % pre-operation to （ 14.6 ± 6.7 ） % （ P = 0. 000） at the 3rd month and （ 15.3 ± 5.5 ） % （P =0. 000） at the 6th month postoperation. The effects were excellent in 28 cases, good in 33 cases, fair in 6 and poor in 2,according to the Nakai criteria with a sum of excellent and good rat

关 键 词：青少年 腰椎间盘突出症 椎间孔镜 maxMore技术 

分 类 号：R726.8[医药卫生—儿科]