经皮椎间盘镜和椎间孔镜下治疗腰椎间盘突出症对腰椎生物力学的影响  

A Biomechanical Effect of Microendoscopic Lumber Discectomy and Transforaminal Endoscopic Spine System in the Treatment of Lumber Disc Herniation

作　　者：赵福伟 张增山[2] 张恒维 马振 田云虎[2] 

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053 [2]潍坊医学院附属医院脊柱外科

出　　处：《潍坊医学院学报》2017年第6期405-407,451,共4页Acta Academiae Medicinae Weifang

摘　　要：目的探讨经皮椎间盘镜(MED)及椎间孔镜技术(TESSYS)下行L_5/S_1腰椎间盘突出髓核摘除术后对腰椎生物力学稳定性的影响。方法选取自2014年1月~2016年12月确诊为腰椎间盘突出症(单阶段,L_5/S_1)在我院接受治疗的病人。根据治疗方式分为对照组:保守治疗患者50例,MED组52例,TESSYS组43例。比较MED组、TESSYS组及对照组L_5/S_1节段经治疗6个月、12个月、24个月后,前屈、后伸、左右侧屈的运动范围改变情况。结果 MED组和TESSYS组术后L_5/S_1节段前屈、后伸及左右侧屈运动范围较对照组相比,差异无统计学意义(P>0.05),并且未发现腰椎不稳。结论腰椎间盘突出症患者行MED和TESSYS手术治疗后,尽管腰椎正常结构遭到破坏,活动范围增加,但短期内不会破坏腰椎稳定性。Objective To study the effect on L5/S1 lumbar spine stability after the treatment of microendoscopic lumbar discectomy（ MED） and transforaminal endoscopic spine system（ TESSYS）. Methods Patients who were diagnosed with lumbar disc herniation（ single stage,L5/S1） treated in our hospital from January 2014 to December 2016 were selected. According to the treatment methods,the patients were divided into three groups. The control group： 50 patients with conservative treatment; MED group： 52 patients; TESSYS group： 43 patients. Range of lumbar flexion,extension and lateral flexion after treatment of 6 months,12 months,24 months were compared. Results Compared with range of flexion,extension and lateral flexion in L5/S1 segmental of MED group and TESSYS group after surgery,the difference was not statistically significant（ P〉0. 05）,and there was no finding lumbar instability. Conclusion After the operation of MED and TESSYS in the patients with lumbar disc herniation,the range of motion increases,but the stability of the lumbar spine will not be disturbed in the short term,although the normal structure of the lumbar spine is damaged. The long term outcome needs further study.

关 键 词：经皮椎间盘镜技术 经皮椎间孔镜技术 腰椎间盘突出症 生物力学 

分 类 号：R681.53[医药卫生—骨科学]