Quadrant微创通道与经皮椎间孔镜技术治疗腰椎间盘突出症的疗效对比  

Comparison of effects of Quadrant minimally invasive channel and percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation

作　　者：张伟学 王猛 曹帅 姜良德[1] 苏宝金[1] ZHANG Wei-xue;WANG Meng;CAO Shuai(Beijing Renhe Hospital,Beijing,102600,China)

机构地区：[1]北京市仁和医院,北京102600

出　　处：《颈腰痛杂志》2018年第2期133-136,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的对比Quadrant微创通道与经皮椎间孔镜技术治疗腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效。方法回顾性分析2015-08-2016-03微创手术治疗的80例LDH患者,其中PTED技术治疗37例,Quadrant微创通道技术治疗43例,统计两组患者的手术时间、住院时间、术后恢复工作时间、并发症情况,以及手术前后(术前、术后3 d及1、3、12个月)的VAS评分、JOA评分和ODI指数等疗效指标,并进行组间对比。结果两组患者手术时间较为相近(P>0.05);但与Quadrant组相比,PTED组的切口长度更小、住院时间和恢复工作时间更短,差异均有统计学意义(P<0.05)。两组患者术后腰痛和腿痛VAS评分和ODI指数均显著下降,JOA评分均显著提高(P<0.05);组间相比,PTED组术后3 d、1个月的腰痛VAS评分显著低于Quadrant组(P<0.05),余无显著性差异(P>0.05)。术后12个月,PTED组的总优良率为91.9%,Quadrant组为95.3%,两组差异无统计学意义(P>0.05)。两组术后并发症情况无显著性差异(P>0.05)。结论采用经皮椎间孔镜与Quadrant微创通道手术治疗LDH患者,均可取得良好疗效。但椎间孔镜技术创伤更小、术后恢复更快,更具微创优势。Objective To compare the clinical efficacy of Quadrant minimally invasive channel and percutaneous transforaminal endoscopic discectomy(PTED)in the treatment of lumbar disc herniation(LDH).Methods From August 2015 toMarch 2016,the clinical data of 80 patients with LDH who were treated with minimally invasive surgery,were retrospectively analyzed.37 cases received PTED treatment,43 cases were treated by Quadrant minimally invasive channel technique.The operation time,hospitalization time,postoperative recovery time,complications,VAS score before and after surgery(before surgery,postoperative 3 d and 1,3,12 months),JOA score,ODI index and other indicators were analyzed and compared between the two groups.Results The operation time of two groups was similar(P>0.05).Compared with the Quadrant group,the length of incision,hospitalization time and recovery time of PTED group were shorter,the differences were statistically significant(P<0.05).After treatment,the low back pain and leg pain VAS scores and ODI index of two groups were significantly decreased,JOA scores were significantly increased(P<0.05).Three days and 1 month after operation,the lowback pain VAS score of PTED group was significantly lower than that of Quadrant group(P<0.05).One year after operation,the total excellent rate of PTED group was 91.9%,and that of Quadrant group was 95.3%,the difference between the two groups was not statistically significant(P>0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion PTED and minimally invasive Quadrant surgery in the treatment of LDH can achieve good results.But the technique of PTED has less trauma,quick recovery and more minimally invasion.

关 键 词：腰椎间盘突出症 经皮椎间孔镜技术 Quadrant微创通道 疗效对比 

分 类 号：R681.5[医药卫生—骨科学]