全脊柱内镜下治疗极外侧型腰椎间盘突出症的疗效评价  

Efficacy assessment of percutaneous endoscopic lumbar discectomy in treatment of far lateral lumbar disc herniation

作　　者：陈小明[1] 张洁[1] 颜学亮[1] 杨铁军[1] 陈亮元[1] 曹奇[1] Xiao-ming Chen;Jie Zhang;Xue-liang Yan;Tie-jun Yang;Liang-yuan Chen;Qi Cao(Department of Spinal Surgery, the Second Affiliated Hospital of University of South China, Hengyang,Hunan 421001, China)

机构地区：[1]南华大学附属第二医院脊柱外科,湖南衡阳421001

出　　处：《中国内镜杂志》2017年第4期57-61,共5页China Journal of Endoscopy

摘　　要：目的评估经皮全脊柱内镜下腰椎间盘切除术(PELD)治疗极外侧型腰椎间盘突出症(FLDH)的临床疗效。方法回顾性分析2014年6月-2015年9月该科采用经皮全脊柱内镜技术治疗FLDH 27例,年龄41~64岁,平均52.3岁,通过观察手术时间、术中出血量和住院时间,采用视觉模拟评分(VAS)评估术前及术后患者腰腿痛情况,改良Mac Nab评分评估患者腰部功能恢复情况。结果单节手术时间为69 min(58~109 min)、术中出血量为18 ml(11~40 ml)、住院时间为5.0 d(3.0~10.0 d),术前VAS评分(8.12±1.25),术后第3天VAS评分(2.80±1.12),术后3个月VAS评分(1.59±1.06),末次随访VAS评分(1.31±0.89),术后VAS评分与术前相比差异均有统计学意义(P<0.05)。采用改良Mac Nab标准评估,优良率为88.9%。结论 PELD治疗FLDH具有创伤小、恢复快等优点,是一种安全、有效的微创手术。Objective To evaluate the clinical efficacy of percutaneous endoscopic lumbar discectomy(PELD)on treatment of far lateral lumbar disc herniation(FLDH).Methods We retrospectively analyzed27patients with FLDH underwent percutaneous endoscopic lumbar discectomy from June2014to September2015,age from41to64,average52.3.The average operation time,intraoperative blood loss and length of hospital stay were collected.The lumbocrural pain perception of patients before and after surgery was assessed by visual analog scale(VAS)and postoperative lumbar functional recovery after surgery by modified MacNab criteria.Results Average operation time was69min(58~109min),intraoperative blood loss was18ml(11~40ml),and length of stay was5.0d(3.0~10.0d).VAS score from(8.12±1.25)preoperatively improved to(2.80±1.12)at the3rd d after operation,(1.59±1.06)at3months after operation,and(1.31±0.89)at the last follow-up after operation;There was a statistical difference between preoperative scores and postoperative scores(P<0.05).Modified MacNab criteria was a ratio of88.9%.Conclusions PELD on the treatment of far lateral lumbar disc herniation have small area of trauma,faster postoperative recovering and several other advantages,which is a safe and effective minimally invasive surgery.

关 键 词：经皮全脊柱内镜下腰椎间盘切除术 腰椎间盘切除术 极外侧型腰椎间盘突出症 微创治疗 

分 类 号：R681.53[医药卫生—骨科学]