经皮椎间孔镜腰椎间盘切除与腰椎后路椎间融合术治疗单节段腰椎间盘突出症疗效比较  

A comparison of percutaneous transforaminal endoscopic discectomy and posteriorlumbar interbody fusionin treating single-segmental lumbar disc herniation

作　　者：蒋健 王业华 王龙 吴继彬 赵德勇 

机构地区：[1]徐州医科大学附属医院骨科,江苏省221000

出　　处：《江苏医药》2017年第11期784-786,共3页Jiangsu Medical Journal

摘　　要：目的比较经皮椎间孔镜腰椎间盘切除术(PTED)与腰椎后路椎间融合术(PLIF)治疗单节段腰椎间盘突出症的疗效。方法腰椎间盘突出症患者40例,按手术方式分为PTED组及PLIF组,每组20例。比较两组患者手术时间、切口长度、术中出血量、术后住院时间,比较术后VAS疼痛评分、Oswestry功能障碍指数(ODI),采用改良MacNab标准评定腰椎功能。结果与PLIF组比较,PTED组手术时间短、切口小、术中出血量少、术后住院时间少(P<0.05)。随访6~10个月。两组术后VAS疼痛评分及ODI均较术前降低(P<0.05);术后1周,PTED组VAS疼痛评分和ODI均低于PLIF组(P<0.05)。根据改良MacNab标准评分,术后6个月,两组腰椎功能差异无统计学意义(P>0.05)。结论 PTED与PLIF治疗腰椎间盘突出症均能取得良好疗效;PTED术中创伤小,术后恢复优于PLIF,近期效果满意。Objective To compare clinical efficacy of percutaneous transforaminal endoscopic discectomy（PTED）and posterior lumbar interbody fusion（PLIF）in treating single-segmental lumbar disc herniation.Methods Forty patients with ingle-segmental lumbar disc herniationwere treated with PTED（group PTED,20 cases）or PLIF（group PLIF,20cases）.The operation time,incision length,intraoperatve blood loss,hospital stay,VAS pain score,oswestry disability index（ODI）and modified MacNab score were compared.Results Compared to group PLIF,group PTED had shorter operation time and incision,less intraoperatve blood loss and shorter hospital stay（P〈0.05）.The patients were followed up for 6 to 10 months,which showed that the VAS pain score and ODI of both groups were improved.In one week after operation,the VAS score and ODI were lower in group PTED than those in group PLIF（P〈0.05）.There was no significant difference between two groups in the excellent and good rate evaluated by modified MacNab in 6 months after operation（P〉0.05）.Conclusion Both of PTED and PLIF are effective in the treatment of lumbar disc herniation.Compared with PLIF,PTED has the advantages of less intraoperative trauma,quicker postoperative recovery and better short-term clinical efficacy.

关 键 词：腰椎间盘突出症 椎间孔镜 腰椎后路椎间融合术 

分 类 号：R687[医药卫生—骨科学]