腰椎间盘突出症患者椎间孔镜术后复发因素的病例对照研究  

Recurrence factors in patients with lumbar disc herniation after percutaneous transforaminal endoscopic:A case-control study

作　　者：文猛 魏腾飞 万云峰 邓博[2] WEN Meng;WEI Tengfei;WAN Yunfeng;DENG Bo(Hunan University of Traditional Chinese Medicine,Changsha 410208,China;The First Department of Spine,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院脊柱一科,湖南长沙410007

出　　处：《中国医药科学》2020年第2期15-18,22,共5页China Medicine And Pharmacy

摘　　要：目的探讨腰椎间盘突出症(LDH)患者经皮椎间孔镜下腰椎髓核摘除术(PELD)术后复发的危险因素。方法回顾2016年7月~2019年3月我院脊柱外科收治的单一节段PELD术后复发患者46例(观察组),随机选取同期的PELD术后未复发患者46例(对照组),对照组均为我院同期PELD手术小组行手术治疗,分别统计两组患者性别、年龄、吸烟、体质指数(BMI)、腰骶部移行椎(LSTV)、突出节段、病理分型、腰椎矢状面运动范围(SROM)并进行分析比较,分析各因素与PELD术后复发的关系。结果年龄≥60岁、BMI>25kg/m2、LSTV、病理分型(突出型)、SROM≥10°均为PELD术后复发的危险因素,但性别、吸烟差异无统计学意义;LSTV的Ⅰb型在L4~5、Ⅲb型在L5S1的突出率最高。结论LSTV是PELD术后复发的危险因素之一,明确PELD术后复发的危险因素,对存在高危因素的人群进行早期干预及个体化分析,有助于减少手术复发率、预估并提高手术治疗效果。Objective To investigate the risk factors of postoperative recurrence in patients with lumbar disc herniation(LDH)after percutaneous endoscopic lumbar discectomy(PELD).Methods 46 patients with relapse of single segment PELD treated in spine department of our hospital from July 2016 to March 2019 were selected as the observation group.46 patients without relapse of PELD in the same period were randomly selected as the control group.The control group was treated with PELD surgery in our hospital during the same period.Gender,age,smoking,body mass index(BMI),lumbosacral transitional vertebra(LSTV),protrusion segments,pathological type,sagittal range of motion(SROM)of the two groups were counted and comparably analyzed,and the relationship between the factors and the recurrence of PELD was analyzed.Results age≥60 years old,BMI>25,LSTV,pathological type(protrusion type),SROM≥10°were all risk factors for postoperative recurrence of PELD,but there was no statistical significance in the difference of gender and smoking;The protrusion rate of LSTV typeⅠb in L4-5,Ⅲb in L5S1 was the highest.Conclusion LSTV is one of the risk factors of postoperative recurrence of PELD.To identify the risk factors of postoperative recurrence of PELD,early intervention and individualized analysis will be conducive to reduce the recurrence rate,predict and improve the effect of treatment effect.

关 键 词：腰椎间盘突出症 椎间孔镜手术 复发 腰骶部移行椎 危险因素 

分 类 号：R687.3[医药卫生—骨科学]