经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出的近期疗效观察  

Short-term clinical efficacy of percutaneous transforaminal endoscopic spine system in the treatment of lumbar disc herniation

作　　者：聂治军[1] 张文芳 张银刚[2] 李全义[1] NIE Zhi-jun;ZHANG Wen-fang;ZHANG Yin-gang;LI Quan-yi(Dept of Orthopaedics,Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi710068,China;Dept of Orthopaedics,the First Affiliated Hospital of Medical School,Xi′an Jiaotong University,Xi′an,Shaanxi710061,China)

机构地区：[1]陕西省人民医院骨科,陕西西安710068 [2]西安交通大学医学院第一附属医院骨科,陕西西安710061

出　　处：《临床骨科杂志》2018年第2期153-156,共4页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金项目(编号:81371987)

摘　　要：目的观察经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症的近期疗效。方法采用TESSYS技术治疗65例腰椎间盘突出症患者,观察患者术后1周及1、3、6个月的疼痛VAS评分和ODI的改善情况,末次随访时采用改良Mac Nab标准评价疗效。结果手术时间60~110 min,术中出血量20~50 ml,术后住院4~7 d。65例均获得随访,时间6~8个月。无神经根损伤、硬膜囊破裂、脑脊液漏、椎间隙感染等并发症发生。术后各时段VAS评分及ODI均较术前明显改善,差异均有统计学意义(P<0.05)。末次随访时根据改良Mac Nab标准评定疗效:优37例,良22例,可6例,优良率为90.77%。结论经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症,具有创伤小、恢复快及近期疗效可靠的优点。严格掌握手术适应证是手术成功的关键和疗效保证。Objective To observe the short-term effect of percutaneous transforaminal endoscopic spine system(TESSYS)in the treatment of lumbar disc herniation.Methods The 65 patients with lumbar disc herniation were treated with TESSYS.VAS and ODI were assessed at 1 week and 1,3,6 months after operation.In addition,the clinical therapeutic effect was evaluated by the modified MacNab standard at the last follow-up.Results The operative time was 60~110 min,blood loss was 20~50 ml,postoperative hospital stay was 4~7 d.The 65 patients were followed up for 6~8 months.No serious complications occurred,such as nerve root injury,dural sac rupture,cerebrospinal fluid leakage,intervertebral disc infection,etc.The VAS and ODI were significantly increased at different periods as compared with those at the preoperation,the differences were statistically significant(P<0.05).In terms of the modified MacNab at the last follow-up,the results were excellent in 37 cases,good in 22,and fair in 6,the excellent and good rate was 90.77%.Conclusions TESSYS technique for the treatment of lumbar disc herniation has the advantages of postoperative minimal trauma,rapid recovery,and reliable short-term efficacy.Strictly mastering surgery indication is the key for the success of operation and the guarantee for the curative effects.

关 键 词：TESSYS 腰椎间盘突出症 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]