两种腰椎间盘切除手术对合并腰骶部移行椎的腰椎间盘突出患者的疗效  

Effect of Two Kinds of Lumbar Discectomy on Patients with Lumbar Disc Herniation Combined with Lumbosacral Transitional Vertebra

作　　者：李智 陈锦鸿 吴文涛 娄朝晖[1] LI Zhi;CHEN Jinhong;WU Wentao;LOU Zhaohui(Department of Orthopedic,the First Afiliated Hospital of Zhengzhou University,Zhenghou 450000,China)

机构地区：[1]郑州大学第一附属医院骨科,河南郑州450000

出　　处：《河南医学研究》2022年第6期992-995,共4页Henan Medical Research

摘　　要：目的比较对于合并腰骶部移行椎(LSTV)患者,传统手术方式与经皮内镜手术切除腰椎间盘并植入融合器治疗腰椎间盘突出症(LDH)的临床效果。方法回顾性分析2017年1月至2019年10月就诊于郑州大学第一附属医院的65例合并LSTV的LDH患者的临床资料,根据手术方式将其分为传统手术方式组(A组,35例)和经皮内镜下腰椎间盘切除术(PELD)手术组(B组,30例)。分别测量两组患者术前及术后腰椎前凸角(LLA)、手术椎体椎间隙高度、过L1中心垂线与S1后缘顶点距离(LASD)、骶骨前倾角(SSA)、下肢及腰背部视觉模拟疼痛评分(VAS)并进行比较分析。结果两组患者术前及术后LLA、SSA、椎间隙高度、LASD比较,差异无统计学意义(P>0.05)。患者术后7dLLA、SSA大于术前,椎间隙高度高于术前,差异有统计学意义(P<0.05);术前与术后7d两组患者LASD比较,差异无统计学意义(P>0.05)。术前两组患者腰背部及下肢VAS评分比较,差异无统计学意义(P>0.05)。术后1a,两组患者下肢VAS评分比较,差异无统计学意义(P>0.05);腰背部VAS评分比较,A组低于B组,差异有统计学意义(P<0.05)。术后1a两组患者腰背部及下肢VAS评分均较术前降低,差异有统计学意义(P<0.05)。结论对于合并有LSTV患者,经皮内镜下腰椎手术与传统手术方式均能改善患者腰背部及下肢症状,传统手术方式术后1a腰背部症状改善效果更佳。Objective Compare the clinical effect of traditional surgery and percutaneous endoscopic surgery for lumbar disc herniation(LDH)and cage implantation in patients with lumbosacral transitional vertebra(ISTV).Methods The clinical data of 65 patients with LDH complicated with LSTV who were treated in the First Affiliated Hospital of Zhengzhou University from January 2017 to October 2019 were retrospectively analyzed.According to the operation methods,they were divided into traditional operation group(35 cases,group A)and percutaneous endoscopic lumbar discectomy(PELD)group(30 cases,group B).The preoperative and postoperative lumbar lordosis angle(LLA),the height of surgical vertebral space,the distance between L central vertical line and S posterior edge vertex,sacral anteversion angle,and visual analogue scale(VAS)score of leg and waist were measured and compared between the two groups.Results There was no statistical difference in LLA,SSA,intervertebral space height and LASD between the two groups before and after operation(P>0.05).The LLA and SSA of the patients 7 days after operation were greater than those before operation,and the height of intervertebral space was higher than that before operation(P<0.05),and there was no statistical difference in LASD(P>0.05).There was no statistical difference in VAS scores of the lower back and lower limbs between the two groups before surgery(P>0.05).One year after operation,there was no statistical difference in the VAS score of the lower limbs between the two groups(P>0.05),and compared with the lower back VAS score,group A was lower than group B(P<0.05).The VAS scores of the lower back and lower limbs in the two groups at one year after operation were lower than those before operation(P<0.05).Condusion For patients with LSTV,percutaneous endoscopic lumbar surgery and traditional surgery can improve the symptoms of patients’lower back and lower limbs,but the traditional surgery has a better effect on the improvement of lumbar symptoms one year after operation.

关 键 词：腰骶部移行椎 腰椎间盘突出症 经皮内镜下腰椎间盘切除术 

分 类 号：R681.5[医药卫生—骨科学]