经皮椎间孔镜治疗极外侧型LDH患者的疗效、MRI腰椎影像参数及JOA评分改变  

Surgical status,MRI lumbar imaging parameters and JOA score changes in patients with extreme posterolateral LDH treated by percutaneous laminectomy

作　　者：王喆[1] 何强[1] 何昊 WANG Zhe;HE Qiang;HE Hao(Department of Ospedics,the Traditional Chinese Medicine Hospital of Bazhong,Bazhong,Sichuan 636000,China)

机构地区：[1]巴中市中医院骨科,四川巴中636000

出　　处：《徐州医科大学学报》2022年第5期330-335,共6页Journal of Xuzhou Medical University

基　　金：四川省卫生健康委员会科研课题(18PJ1187)。

摘　　要：目的探究经皮椎间孔镜技术治疗极外侧型腰椎间盘突出症(LDH)患者的效果。方法选取巴中市中医院骨科极外侧型LDH患者60例,随机数字表法分为2组,各30例。对照组给予常规椎板间隙开窗间盘摘除术,研究组给予经皮椎间孔镜下椎间盘髓核摘除术。比较2组手术出血量、手术时间、住院天数、手术前后磁共振成像(MRI)腰椎影像参数、疼痛视觉模拟评分(VAS评分)、腰椎功能(JOA)评分、神经根Lindblon分级、下肢神经传导速度及疗效优良率。结果研究组术中失血量少于对照组,住院天数短于对照组(P<0.05);术后6个月,研究组VAS评分低于对照组,JOA评分、下肢神经传导速度、疗效优良率高于对照组,神经根Lindblon分级、MRI腰椎影像参数优于对照组(P<0.05)。结论经皮椎间孔镜技术治疗极外侧型LDH能改善患者MRI腰椎影像参数、下肢神经传递,缓解腰腿痛,提高腰椎功能,效果显著。Objective To explore the effectiveness of percutaneous transforaminal endoscopy on patients with extreme lateral lumbar disc herniation(LDH).Methods A total of 60 patients with extreme lateral LDH in the Traditional Chinese Medicine Hospital of Bazhong were selected.According to the random number table method,they were divided into two groups(n=30):a control group and an observation group.The control group received routine laminectomy and discectomy,while the study group underwent percutaneous foraminal endoscopic discectomy.Both groups were compared for intraoperative blood loss,operation time,the length of hospitalization stay,magnetic resonance imaging(MRI)parameters of lumbar spine before and after operation,VAS score,and lumbar spine function(JOA)score,the Lindblon grade of the nerve roots,lower limb nerve conduction velocity and the excellent and good rates of therapeutic effects were compared between the two groups.Results The study group showed less blood loss and shorter length of hospitalization stay than the control group(P<0.05).Six months after operation,the study group presented decreases in VAS scores,increases in JOA scores,lower limb nerve conduction velocity and the excellent and good rates of therapeutic effect,and improvement in Lindblon grades of the nerve roots and MRI lumbar imaging parameters,compared with the control group(P<0.05).Conclusions Treatment of extreme lateral LDH with percutaneous transforaminal endoscopy can improve MRI lumbar spine imaging parameters and lower limb nerve transmission,relieve lumbar and leg pain,and improve lumbar spine function,with significant effects.

关 键 词：极外侧型腰椎间盘突出症 经皮椎间孔镜技术 MRI腰椎影像参数 改良经椎间孔腰椎椎体间融合术 

分 类 号：R681.53[医药卫生—骨科学]