改良椎间孔镜手术治疗合并Ⅰ度滑脱腰椎间盘突出症  

Improved percutaneous transforaminal endoscopic discectomy(PTED)for treatment of lumbar disc herniation accompanied with grade Ⅰ spondylolisthesis

作　　者：赵龙[1] 葛鹏[2] 张荣宜 ZHAO Long;GE Peng;ZHANG Rong-Yi(The First Affiliated Hospital,Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院疼痛科,安徽合肥230022 [2]安徽医科大学第一附属医院脊柱外科,安徽合肥230022

出　　处：《中国矫形外科杂志》2021年第23期2200-2202,共3页Orthopedic Journal of China

基　　金：安徽省自然科学基金面上项目(编号:斗基2018-17号)。

摘　　要：[目的]探讨改良椎间孔镜手术治疗合并I度滑脱腰椎间盘突出症的短期临床疗效。[方法]回顾分析本院2018年1月-2019年12月收治的57例合并Ⅰ度滑脱腰椎间盘突出症连续接受改良椎间孔镜手术患者的临床资料,比较术前、术后不同时间点疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分及椎体滑脱度(%)的差异,同时采用改良MacNab法对术后12个月进行疗效评定。[结果]57例患者均顺利完成手术,无血管、神经损伤等并发症。所有患者均获随访,随访时间18〜30个月,平均(21.22±4.78)个月,术后各时间点VAS及ODI评分较术前均显著降低,差异有统计学意义(P<0.05),末次随访时改良MacNab标准为优良率89.47%。术后12个月门诊复查,均无椎间盘突出复发。[结论]改良椎间孔镜手术治疗合并Ⅰ度滑脱腰椎间盘突出症安全、有效,短期效果满意。[Objective]To explore the short-term outcomes of improved percutaneous transforaminal endoscopic discectomy(PTED)for lumbar disc herniation accompanied with grade Ⅰ spondylolisthesis.[Methods]A total of 57 patients received improved percutaneous transforaminal endoscopic discectomy(PTED)for lumbar disc herniation accompanied with grade Ⅰ spondylolisthesis from January 2018 to December 2019 in our hospital.The visual analogue Scale(VAS),Oswestry Disability Index(ODI)and vertebral body slippage(%)were compared among different time points.Meanwhile,the MacNab criteria was used to evaluate the clinical outcomes at the 12th month after surgeiy.[Results]All patients had operations completed successfully,without nerve injury,infection or other serious complications.All the patients were followed up for 18〜30 months with a mean of(21.22±4.78)months.VAS and ODI score at all time points postoperatively were improved compared with those before surgery(P<0.05).At the last follow-up,the excellent and good rate based on the modified MacNab's criteria was 89.47%.No postoperative recurrence of disc herniation was found in anyone of them.[Conclusion]This improved percutaneous transforaminal endoscopic discectomy is safe and effective treatment for lumbar disc herniation accompanied with grade Ⅰ spondylolisthesis,does achieve satisfactory short-term outcomes.

关 键 词：椎间孔镜手术 腰椎滑脱 腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学]