经皮椎间孔镜技术行腰椎间盘髓核摘除术的并发症以及原因分析  

The complications and causes of discectomy of lumbar intervertebral disc by percutaneous transforaminal endoscopic technique

作　　者：汝磊 袁根 宗训付 欧阳超[1] RU Lei;YUAN Gen;ZONG Xun-fu;OUYANG Chao(Department of Orthopedics,Fuyang Cancer Hospital,Fuyang,Anhui 236000,China)

机构地区：[1]阜阳市肿瘤医院骨科,安徽阜阳236000

出　　处：《颈腰痛杂志》2021年第2期193-195,共3页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的探讨应用经皮椎间孔镜技术行腰椎间盘髓核摘除术的并发症发生原因,以期为临床防治提供理论依据和指导。方法收集自2019年1月~2020年8月本院骨科收治的60例腰椎间盘突出症患者,均由同一团队施行经皮椎间孔镜下髓核摘除术。其中男性26例,女性34例;年龄25~83岁,平均(56.37±12.44)岁;所有患者均为单节段突出,统计并记录患者的术中并发症和术后并发症,并分析其原因。结果患者术后1 d、1个月和3个月的VAS评分明显低于术前,差异有统计学意义(F=9.074,P<0.05)。术中并发症包括皮肤贴膜进入术野1例,导丝断裂1例,硬脊膜撕裂1例,脑脊液渗漏2例和局麻药物过敏2例;术后并发症包括神经根水肿3例,血肿压迫神经根3例,髓核残留1例,椎间隙感染2例和足下垂1例。结论利用经皮椎间孔镜技术行腰椎间盘髓核摘除术具有良好的应用前景;保持有良好的手术习惯,做好术前评估,注意手术细节,可很好地避免术中和术后并发症的发生。Objective To explore the causes of complications of percutaneous transforaminal endoscopic discectomy for lumbar disc herniation.Methods From January 2019 to August 2020,60 patients with lumbar disc herniation who were treated in our hospital were collected.All of them performed percutaneous transforaminal endoscopic discectomy by the same team.There were 26 males and 34 females,with an average age of(56.37±12.44)years old,ranged from 25 to 83 years old.All patients had single segment herniation.The intraoperative and postoperative complications were recorded and analyzed.Results The VAS scores at 1 day,1 month and 3 months after operation were significantly lower than before operation(F=9.074,P<0.05).The intraoperative complications included 1 case of skin patch entering the operation field,1 case of broken guide wire,1 case of dural tear,2 cases of cerebrospinal fluid leakage and 2 cases of local anesthetic allergy.Postoperative complications included nerve root edema in 3 cases,hematoma compression in 3 cases,residual nucleus pulposus in 1 case,intervertebral infection in 2 cases and foot drop in 1 case.Conclusion Percutaneous transforaminal endoscopic discectomy has good application prospect;keeping good habit of operation,good preoperative evaluation and paying attention to the details of operation can well avoid the occurrence of intraoperative and postoperative complications.

关 键 词：腰椎间盘突出症 经皮椎间孔镜 并发症 原因 

分 类 号：R619[医药卫生—外科学]