经皮椎间孔入路与经皮椎板间入路治疗腰椎间盘突出症效果观察  

Discussion on operative approach of percutaneous endoscope in treatment of L5/S1 lumbar disc herniation

作　　者：王松茂[1] 侯秀伟[1] 徐永辉[1] 胡军华[1] 刘雅普[1] 李鹏[1] 吴广良[1] Wang Songmao;Hou Xiuwei;Xu Yonghui;Hu Junhua;Liu yapu;Li Peng;Wu Guangliang(The second affiliated hospital of luohe medical college,henan Luohe462300,China)

机构地区：[1]河南漯河医学高等专科学校第二附属医院,漯河462300

出　　处：《河南外科学杂志》2021年第1期30-33,共4页Henan Journal of Surgery

基　　金：骨科团队项目(2019-LYZTD011)。

摘　　要：目的探讨经皮椎间孔入路与经皮椎板间入路经皮椎间孔镜技术(PTED)治疗腰椎间盘突出症(LDH)的效果。方法前瞻性纳入2015-10—2019-03间于漯河医学高等专科学校第二附属医院行PTED治疗的125例LDH患者。根据手术入路方式分为经椎间孔入路组(椎间孔组)和经椎板间入路组(椎板间组)。比较2组患者的基线资料、围术期相关指标,以及术前和术后第1天、3个月、12个月的腰腿痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)。结果共纳入125例患者,椎间孔组68例,椎板间组57例。2组患者的基线资料差异无统计学意义(P>0.05)。椎板间组的手术时间、术中透视次数均低于椎间孔组,差异有统计学意义(P<0.05)。2组术后各时间点的VAS评分及ODI指数均较术前显著性改善,差异有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05)。结论经皮椎板间入路和经皮椎间孔入路PTED治疗LDH,均可显著改善患者的VAS评分及ODI指数评分,差异无统计学意义。但需更大样本前瞻性随机对照研究予以证实。Objective To investigate the effect of percutaneous foraminal approach and percutaneous intervertebral foram(PTED)in the treatment of lumbar disc herniation(LDH)by percutaneous foraminal approach.Methods Prospective inclusion from 2015-10 to 2019-03 of 125 LDH patients treated in the second affiliated Hospital of Luohe Medical College.According to the surgical approach,it can be divided into transforaminal approach group(interforaminal group)and transvertebral interplate approach group(intervertebral group).Comparison of baseline data and perioperative indicators in 2 groups,Lumbar and leg pain visual analogue scale(VAS),Oswestry dysfunction index(ODI).Results A total of 125 patients were included,68 patients in intervertebral foramen group and 57 patients in lamina intervertebral group.Baseline data of 2 groups were not statistically significant(P>0.05).Compared with the intervertebral foramen group,the operative time and intraoperative fluoroscopy times were significantly lower in the intervertebral foramen group(P<0.05).The VAS score and ODI index of the two groups were significantly improved(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion Percutaneous interlaminar approach and percutaneous foraminal approach PTED significantly improved the VAS score and ODI index score of patients.However,larger sample prospective randomized controlled studies are needed to confirm it.

关 键 词：腰椎间盘突出症 椎间孔镜 经椎间孔入路 经椎板间入路 

分 类 号：R681.5[医药卫生—骨科学]