椎间孔镜Ⅰ SEE技术治疗腰椎管狭窄合并腰椎间盘突出症——附10例患者  

Technique Ⅰ SEE of PELD for treatment of lumbar disc herniation and stenosis

作　　者：徐峰 李涛[2] 胡昊 徐彬[2] 谭林英 张建[2] 伍博宇 席金涛 

机构地区：[1]解放军武汉总医院,湖北武汉430000 [2]湖北中医药大学研究生院,湖北武汉430070

出　　处：《中国矫形外科杂志》2018年第3期260-265,共6页Orthopedic Journal of China

基　　金：基金项目：湖北省自然科学基金项目(编号：2014CFB473;WJ2017H0033)

摘　　要：[目的]探讨椎间孔镜Ⅰ SEE技术治疗腰椎管狭窄合并腰椎间盘突出症的近期疗效。[方法]回顾性分析2017年1月~2017年3月于本院应用椎间孔镜Ⅰ SEE技术治疗并获得随访的10例腰椎管狭窄合并腰椎间盘突出症患者的临床资料,采用视觉模拟评分法(visual analogue scale/score,VAS)评估手术疗效,应用日本骨科协会(Japanese Orthopaedic Association Scores,JOA)评分对腰椎功能进行评估,并计算JOA改善率。[结果]手术时间60~110min,平均88 min;出血量5~20 ml,平均11.5 ml;住院时间3~7 d,平均5.4 d。所有患者随访3~6个月,平均4.5个月。术前VAS评分为(8.10±0.61)分,术后3 d VAS评分为(2.81±0.40)分,末次随访为(1.44±0.28)分。术前与术后3 d、末次随访比较差异有统计学意义(P<0.05);术前JOA评分为(7.93±0.73)分,出院当天评分为(18.73±0.91)分,末次随访评分为(31.16±1.10)分,术前与出院时、末次随访比较差异有统计学意义(P<0.05)。根据JOA评分标准计算改善率,优8例,良1例,可1例,差0例。[结论]应用椎间孔镜I see技术治疗腰椎管狭窄合并腰椎间盘突出症疗效确切,具有创伤小、手术时间短、恢复快、术后并发症少等优点。[Objective] To explore the short-term outcome of technique 1 see of PELD in treatment of lumbar disc hernia- tion and stenosis. [Methods] The clinical data of 10 patients treated with technique 1 see of PELD for lumbar spinal stenosis combined with lumbar disc herniation were retrospectively analyzed from January 2017 to March 2017 in our hospital. The visu- al analogue scale （VAS） and Japanese Orthopaedic Association Scores （JOA） was used for evaluation of the outcome. [Results] The operation in the 10 patients lasted for 60-110 minutes （88 minutes on average）, associated with blood loss from 5 to 20 ml （11.5 ml on average）, hospital stay from 3 to 7d, （5.4 d on average）. All patients were followed for 3-6 months, with an average of 4.5 months. The VAS significantly decreased from （8.10±0.61） ploperatively to （2.81＋0.40） at 3 days after surgery, further to （1.44±0.28） at the latest follow-up （P〈0.05）. By contrast, the JOA score significantly increased from （7.93±0.73） preoperative- ly, to （18.73±0.91） at the discharged day, further to （31.16±1.10） at the latest follow up （P〈0.05）. In term of JOA improved rate, the results were graded as excellent in 8, good in 1, fair in 1 and poor in 0. [Conclusion] Application of technique I see of PEID for treatment of lumbar disc herniation and stenosis is effective, with advantages of minimized trauma, shortened operation time, quicker recovery and less postoperative complications.

关 键 词：椎间孔镜I SEE技术 腰椎管狭窄症 腰椎间盘突出症 

分 类 号：R738.1[医药卫生—肿瘤]