工作套管保护下经皮椎间孔内镜扩大成形术在腰椎间盘摘除术中的应用  

Percutaneous transforaminal endoscopic lumbar discectomy with intervertebral foramen expanding plasty under the protective working tube in the treatment of lumbar intervertebral disc herniation

作　　者：韩卫江[1] 李霞[1] 安圆[1] 宋文阁[2] 孙茜若 李龙光[1] 赵根懋 刘平华[1] 

机构地区：[1]西双版纳州人民医院疼痛科,云南省景洪市666100 [2]山东大学附属省立医院疼痛科,济南市250021

出　　处：《实用疼痛学杂志》2017年第5期332-336,共5页Pain Clinic Journal

摘　　要：目的探讨工作套管保护下经皮椎间孔内镜扩大成形术在腰椎间盘摘除术（PELD）中的安全性和有效性。方法选择腰椎间盘突出症患者96例，采用工作套管保护下行PELD术。观察椎间孔扩大成形及纤维环保护情况。比较手术前及术后7d、3个月、6个月、12个月时视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI），并采用MacNab方法评定治疗效果。结果椎间孔成形与纤维环保护良好。与术前比较，手术后不同时点患者VAS较术前均明显降低（P〈0．05），术后ODI均明显下降（｜P〈0．05）。手术后12个月时疗效为优者70例，良者22例，可者4例，差者0例，优良率95．8％。所有患者未见神经损伤及并发症发生。结论工作套管保护下内镜椎间孔扩大成形术治疗腰椎间盘突出症安全、有效。Objective To discuss the safety and effectiveness of percutaneous transforaminal endo- scopic lumbar discectomy （PELD） with intervertebral foramen expanding plasty under the protective working tube. Methods Ninety-six patients with lumbar intervertebral disc herniation were underwent PELD in pro- tecting with working tube. The situation of the intervertebral foramen expand plasty and fibrous ring protection were observed. VAS and ODI of all patients before operation and at 7 d, 3 months, 6 months, 12 months after operation were evaluated and compared. MacNab method was used to assess the efficacy of treatment. Re- sults The situation of the intervertebral foramen expanding plasty and fibrous ring protection were good. Com- pared with preoperation, VAS and ODI were both significantly reduced in different evaluation time points after operation （P〈0.05）. The efficacy evaluation results were excellent in 70 eases, good in 22 cases, general in 4 cases, poor in 0 case, the excellent and good rate was 95.8%. No nerve damage and other complications were found. Conclusion Intervertebral foramen expanding plasty under the protective working tube in the applica- tion of PELD is safe and effective for the treatment of intervertebral disc herniation.

关 键 词：椎间孔扩大成形 椎间孔镜 腰椎间盘突出症 疼痛 

分 类 号：R687.3[医药卫生—骨科学]