经皮椎间孔镜单切口治疗双节段腰椎间盘突出症的疗效  

Percutaneous endoscopic lumbar discectomy for treatment of double-segmental lumbar disc herniation through a single incision

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,武汉430000 [2]湖北中医药大学研究生院,武汉430070

出　　处：《中国矫形外科杂志》2018年第5期385-389,共5页Orthopedic Journal of China

基　　金：湖北省自然科学基金项目(编号:2014CFB473);国家自然科学基金项目(编号:81401802)

摘　　要：[目的]探讨运用经皮椎间孔镜单切口治疗双节段腰椎间盘突出症的可行性及其疗效。[方法]回顾性分析2010年3月～2016年3月在本院接受经皮椎间孔镜单切口手术并获得随访的27例双节段腰椎间盘突出症患者资料,采用视觉模拟评分法(visual analogue scale,VAS)、功能指数评分(Oswestry Disability Index,ODI)和改良Mac Nab标准评估手术疗效。[结果]所有患者手术时间75～135 min,平均95 min;出血量15～25 ml,平均20 ml;住院时间3～14 d,平均6 d。所有患者随访9～60个月,平均26个月。VAS评分术前(9.00±0.35)分,出院时(3.15±1.25)分,术后1个月(2.51±1.67)分,末次随访时(1.41±0.33)分,术前与术后比较差异有统计学意义(P<0.05);ODI评分术前(71.21±15.22)分,出院时(29.46±9.23)分,术后1个月(17.58±7.16)分,末次随访时(10.13±5.29)分,术前与术后比较差异有统计学意义(P<0.05)。改良Mac Nab标准评价临床疗效:优18例,良6例,可1例,差2例,优良率为88.9%(24/27)。[结论]经皮椎间孔镜单切口治疗双节段腰椎间盘突出症对术者要求高,但具有创伤小、并发症少、术后恢复快等优点,具有可行性且安全。[Objective] To explore the feasibility and efficiency of percutaneous endoscopic lumbar discectomy （PELD） for treatment of double-segment lumbar disc herniation through a single incision. [Methods] A retrospective study was conducted on 27 patients who underwent PELD through a single incision for treatment of double-segment lumbar disc herniation from March 2010 to March 2016 in our hospital. The visual analogue scale （VAS） , Oswestry Disability Index （ODI） and modified MacNab criteria were used to evaluate the outcomes. [Results] All the patients underwent operation successfully with operation time of 95 rain on average （75±135 min）, blood loss of 20 ml （15-25 ml） and hospital stay of 6 days （3-14 days）. All the pa- tients were followed up for an average of 26 months （9-60 months）. The VAS significantly decreased from （9.00±0.35） preopera- tively to （3.15±1.25） at discharge, （2.51±1.67） at 1month after surgery and （1.41±0.33） at the latest follow-up （P〈0.05）. Like- wise, the ODI statistically reduced from （71.21± 15.22） preoperatively to （29.46±9.23） at discharged, （17.58±7.16） at 1 month postoperatively and （10.13±5.29） at the latest follow-up （P〈0.05）. In term of modified MacNab criteria, the clinical results grad- ed as excellent in 18 patients, good in 6, fair in 1 and poor in 2, with satisfactory rate of 88.9%（24/27）. [Conclusion] Percutane- ous endoscopic lumbar discectomy through a single incision is feasible and safe technique for treatment of double-segment lum- bar disc herniation with sound clinical consequences, which should be performed by experienced surgeon, however take advan-tages of minimized trauma, reduced complications and im- proved postoperative recovery.

关 键 词：经皮椎间孔镜腰椎间盘切除术 腰椎间盘突出症 单切口 双节段 

分 类 号：R681.53[医药卫生—骨科学]