不同入路经皮椎间孔镜治疗中央型腰椎间盘突出症的效果对比  

Comparison of the Effect of Percutaneous Transforaminal Endoscopic Discectomy with Different Approaches in the Treatment of Central Lumbar Disc Herniation

作　　者：田中[1] 宋奇志[1] 裴建祥[1] TIAN Zhong;SONG Qizhi;PEI Jianxiang(Steel General Hospital,Chongqing 400000,China)

机构地区：[1]重钢总医院,重庆400000

出　　处：《中外医学研究》2021年第11期145-148,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨不同入路经皮椎间孔镜技术(PTED)治疗中央型腰椎间盘突出症(CLDH)的效果。方法:选取本院2018年1月-2019年12月行PTED治疗CLDH的56例患者。按掷硬币法分为对照组和试验组,各28例。对照组采取侧后方入路,试验组采取椎板间隙入路。比较两组的治疗效果、手术情况、术前和术后6个月的疼痛程度[视觉模拟评分(VAS评分)]、腰椎功能[日本骨科协会评分,JOA评分]及术中、术后并发症发生率。结果:试验组疗效优于对照组(P<0.05);试验组手术时间短于对照组(P<0.05),两组术中出血量、术后卧床时间比较差异无统计学意义(P>0.05);术后6个月,试验组JOA评分高于对照组,VAS评分低于对照组(P<0.05);试验组脊神经根损伤发生率(3.57%)低于对照组(21.43%),差异有统计学意义(P<0.05)。结论:选择椎板间隙入路PTED治疗CLDH,可明显改善腰椎功能和减轻术后疼痛程度,能有效提高临床疗效,且并发症少。Objective:To investigate the effect of percutaneous transforaminal endoscopic discectomy(PTED)with different approaches in the treatment of central lumbar disc herniation(CLDH).Method:From January 2018 to December 2019,56 patients who underwent PTED for CLDH in our hospital were divided into the control group and the experimental group by coin flipping method,with 28 patients in each group.The control group was treated by lateral posterior approach,and the experimental group was treated by intervertebral disc space approach.The treatment effect,operation condition,pain degree(visual analogue scale,VAS score),lumbar vertebral function(Japanese orthopaedic association score,JOA score)before and 6 months after surgery and incidence of intraoperative and postoperative complications of the two groups were compared.Result:The efficacy of the experimental group was better than that of the control group(P<0.05);the operation time of the experimental group was shorter than that of the control group(P<0.05),and there was no significant difference in intraoperative blood loss and postoperative bed rest time between the two groups(P>0.05).Six months after surgery,the JOA score of the experimental group was higher than that of the control group,and the VAS score was lower than that of the control group(P<0.05).The incidence of spinal nerve root injury in the experimental group(3.57%)was lower than that of the control group(21.43%),the difference was significant(P<0.05).Conclusion:PTED through intervertebral disc space approach for CLDH can significantly improve lumbar spine function and reduce postoperative pain,effectively improve clinical efficacy,and have few complications.

关 键 词：中央型腰椎间盘突出症 经皮椎间孔镜技术 不同入路 疼痛 

分 类 号：R687.3[医药卫生—骨科学]