改良T氏椎间孔镜技术对腰椎间盘突出症伴椎管狭窄患者腰椎功能及预后的影响分析  

Effect and Prognosis of Modified T-type Foramen Endoscopy Technique on Lumbar Function in Patients with Lumbar Disc Herniation and Spinal Stenosis

作　　者：张慧森 田斌武 陈雷[1] 刘凯恒 刘健[1] 温石磊 ZHANG Huisen;TIAN Binwu;CHEN Lei;LIU Kaiheng;LIU Jian;WEN Shilei(Department of Orthopaedics,Bao Ding NO.1 Hospital of TCM,Baoding 071000,Hebei Province,China)

机构地区：[1]保定市第一中医院骨科,河北保定071000

出　　处：《吉林中医药》2020年第10期1339-1342,共4页Jilin Journal of Chinese Medicine

基　　金：保定市科技计划项目(18ZF102)。

摘　　要：目的分析改良T氏椎间孔镜技术对腰椎间盘突出症伴椎管狭窄患者腰椎功能的影响及预后。方法选取2018年1月-2019年5月保定市第一中医院骨科收治的腰椎间盘突出症合并椎管狭窄的患者60例,根据手术方式的不同将其分为观察组(n=30)和对照组(n=30)。观察组采用改良T氏椎间孔镜技术治疗,对照组采用椎板减压髓核摘除椎间融合椎弓根钉内固定术治疗。对比2组患者VAS、JOA、ODI评分、总缓解率、Oswestry功能障碍指数总优良率。结果与手术前比,手术后3个月,2组JOA评分升高,且观察组高于对照组;2组腰痛、下肢痛VAS评分、ODI评分降低,且观察组低于对照组。观察组手术后3个月总缓解率及Oswestry功能障碍指数总优良率高于对照组(均P <0.05)。结论改良T氏椎间孔镜技术可有效缓解腰椎间盘突出症合并椎管狭窄患者临床症状,改善腰腿疼痛情况,且疗效优于椎板减压髓核摘除椎间融合椎弓根钉内固定术的治疗,值得临床推广应用。Objective To analyze the effect and prognosis of modified T-type foramen endoscopy technique on lumbar function in patients with lumbar disc herniation and spinal stenosis, and to analyze its effect on relieving lumbar and leg pain. Methods From January 2018 to May 2019, 60 patients of lumbar disc herniation with spinal stenosis syndrome, were selected and divided into observation group(n=30) and control group(n=30) according to dif ferent surgical methods. The observation group was treated with modified T-foramen endoscopy, while the control group was treated with laminectomy, nucleus pulposus removal and pedicle screw fixation. JOA, ODI scores, total remission rate, and Oswestry dysfunction index were compared between the two groups. Results Compared with before operation, JOA score of the two groups were higher 3 months after operation, and the observation group was higher than that of the control group;ODI score, VAS score of low back pain and lower limb pain of the two groups was lower, and that of the observation group was lower than that of the control group. The total response rate and Oswestry dysfunction index total excellent and good rate in the observation group 3 months after surgery were higher than those in the control group(all P<0.05). Conclusion The modified T-type foramen endoscopy can effectively relieve the clinical symptoms of patients of lumbar disc herniation with spinal stenosis syndrome, improve the pain of lumbar and leg, and the curative effect is better than that of laminectomy, nucleus pulposus removal and pedicle screw fixation. It is worthy of clinical application.

关 键 词：腰椎间盘突出症合并椎管狭窄症 改良T氏椎间孔镜技术 疼痛视觉模拟量表 日本骨科学会 腰椎功能 

分 类 号：R684[医药卫生—骨科学]