两种术式治疗腰椎间盘突出症的疗效比较  

Comparison of therapeutic effect of two methods for treatment of lumbar disc herniation

作　　者：张洋 尚晖[1] 郭晓鹏[1] ZHANG Yang;SHANG Hui;GUO Xiao-peng(Dept of Spinal Surgrey,Taihe Hospital of Shiyan City,Shiyan,Hubei 442000,China)

机构地区：[1]十堰市太和医院脊柱外科,湖北十堰442000

出　　处：《临床骨科杂志》2022年第3期342-346,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较可扩张微创通道(经Quadrant通道)系统下单纯髓核摘除术与经皮椎间孔镜下经椎间孔内镜脊柱系统(TESSYS)技术治疗腰椎间盘突出症的疗效。方法根据手术方式不同将177例腰椎间盘突出症患者分为对照组(采用经Quadrant通道系统下单纯髓核摘除术,91例)和观察组(采用TESSYS技术,86例)。记录两组手术情况及并发症发生情况,采用腿痛VAS评分、JOA评分、ODI及改良MacNab标准评价临床疗效。结果患者均获得12个月随访。切口长度、术中出血量、住院时间观察组均短(少)于对照组(P<0.05),手术时间两组比较差异无统计学意义(P>0.05)。腿痛VAS评分、JOA评分、ODI:两组术后3 d、术后3个月、末次随访时均较术前显著改善(P<0.05)。腿痛VAS评分:术后3 d观察组低于对照组(P<0.05);术后3个月、末次随访时两组比较差异均无统计学意义(P>0.05)。JOA评分、ODI:术后3 d、术后3个月、末次随访时两组比较差异均无统计学意义(P>0.05)。末次随访时改良MacNab标准优良率两组比较差异无统计学意义(P>0.05)。手术并发症发生率观察组高于对照组(P<0.05)。结论与经Quadrant通道技术相比,TESSYS技术具有创伤小、恢复快的优点,但术后日光灼烧综合征和椎间盘突出复发率高。Objective To compare the curative effect of expandable minimally invasive channel(Quadrant channel)system pure nucleus pulposus excision and transforaminal endoscopic spine system(TESSYS)technique in the treatment of lumbar disc herniation.Methods According to different surgery methods,177 patients with lumbar intervertebral disc herniation were divided into the control group and observation group.The 91 cases of the control group was performed with Quadrant channel system pure nucleus pulposus excision,and 86 cases of the observation groups were adopted with TESSYS technique.The operation conditions and complications occurrence were recorded.Clinical efficacy was evaluated by leg pain VAS,ODI score,JOA score and modified MacNab standard.Results All patients were followed up for 12 months.The incision length,intraoperative blood loss and length of hospital stay in the observation group were all shorter(less)than those in the control group(P<0.05),while the operative time had no statistical significance between the two groups(P>0.05).Compared with before surgery,the leg pain VAS,JOA score and ODI score in the two groups were significantly improved at 3 d after surgery,3 months after surgery and the last follow-up(P<0.05).The leg pain VAS:observation group was lower than control group at 3 d after operation(P<0.05);there were no significant differences between the two groups at 3 months postoperation and the last follow-up(P>0.05).JOA score and ODI scores:there were no significant differences between the two groups at 3 d,3 months postoperation and the last follow-up(P>0.05).At the last follow-up,there was no significant difference in the excleent-good rate of modified MacNab standard between the two groups(P>0.05).The incidence rate of the complications:the observation group was higher than the control group(P<0.05).Conclusions Compared with Quadrant channel technique,TESSYS technique has the advantages of less trauma and faster recovery,but the recurrence rate of postoperative sunburn syndrome and disc herniation

关 键 词：腰椎间盘突出症 椎间孔镜手术 可扩张Quadrant通道微创系统 

分 类 号：R681.57[医药卫生—骨科学] R687.3[医药卫生—外科学]