单侧双通道内镜治疗重度脱垂型腰椎间盘突出症  

Unilateral biportal endoscopy for far-migrated lumbar intervertebral disc herniation

作　　者：曹臣[1] 陈书连[1] 高延征[1] 张广泉[1] 丁帅[1] 艾进伟 张锴 侯志强 CAO Chen;CHEN Shu-lian;GAO Yan-zheng;ZHANG Guang-quan;DING Shuai;AI Jin-wei;ZHANG Kai;HOU Zhi-qiang(Department of Spine Surgery,People’s Hospital of Henan Province,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院脊柱脊髓外科,河南郑州450003

出　　处：《中国矫形外科杂志》2022年第3期273-276,共4页Orthopedic Journal of China

摘　　要：[目的]评价单侧双通道内镜治疗重度脱垂型腰椎间盘突出症的临床疗效.[方法] 2020年4月-2020年12月,在本科行单侧双通道内镜治疗的重度脱垂型腰椎间盘突出症患者19例.总结围手术期、随访与影像学结果.[结果]所有患者手术均顺利完成,无严重并发症,手术时间(75.37±13.62) min,出血量(61.84±20.45) ml,透视次数(2.84±0.83)次.术后患者腰部及下肢VAS评分显著持续下降(P<0.05),至术后30 d患者疼痛基本消失.随时间推移,患者改良ODI评分显著下降,而JOA评分显著增加(P<0.05).按改良Macnab标准,末次随访时的临床疗效:优16例,良2例,可1例,优良率94.74%.至末次随访时,MRI显示手术节段无突出复发.[结论]单侧双通道内镜是治疗重度脱垂型腰椎间盘突出症的有效方法.[Objective]To explore the clinical efficacy of unilateral bi portal endoscopy for far-migrated lumbar intervertebral disc her・niation.[Methods]From April 2020 to December 2020,19 patients underwent unilateral bi portal endoscopy for far-mi grated lumbar intervertebral disc herniation in our department.The documents of perioperative period,follow-up and radiographic results were summarized.[Results]All patients had operation completed successfully without serious complications,while with operation time of(75.37±13.62)min,blood loss of(61.84±20.45)ml,and times of fluoroscopy of(2.84±0.83).The VAS score for lower back pain and leg pain continued to decrease significantly after the operation(P<0.05),and the pain almost disappeared by 30 days after the operation.The modified ODI score decreased significantly,while the JOA score increased significantly over time(P<0.05).Based on Modified Macnab criterion,the clinical outcomes were marked as excellent in 16 cases,good in 2 cases and fair in 1 case with excellent and good rate of 94.74%.At the latest follow-up,MRI showed far-migrated lumbar intervertebral discs were successfully removed without recrudescence.[Conclusion]Unilateral biportal endoscopy is an effective method for treatment of far-migrated lumbar intervertebral disc herniation.

关 键 词：重度脱垂腰椎间盘突出症 单侧双通道内镜 临床疗效 

分 类 号：R681.53[医药卫生—骨科学]