经皮椎间孔镜椎间盘切除术与经椎间孔椎体间融合术治疗腰椎间盘突出合并椎管狭窄症的疗效  

Effect of percutaneous transforaminal endoscopic discectomy and transforaminal lumbar interbody fusion in the treatment of lumbar disc herniation complicated with spinal stenosis

作　　者：步国强[1] 郝为民 刘玉亮 宋国华 BU Guoqiang;HAOWeimin;LIU Yuliang;SONG Guohua(Department of Spinal Surgery,Heze Municipal Hospital,Heze,Shandong,274000,China)

机构地区：[1]菏泽市立医院脊柱外科,山东菏泽274000

出　　处：《当代医学》2022年第17期50-53,共4页Contemporary Medicine

摘　　要：目的探讨经皮椎间孔镜椎间盘切除术与经椎间孔椎体间融合术治疗腰椎间盘突出合并椎管狭窄症的疗效。方法选取2019年4月至2021年4月本院收治的64例确腰椎间盘突出合并椎管狭窄症患者作为研究对象,按随机数字表法分为A组和B组,每组32例。A组采用经皮椎间孔镜椎间盘切除术,B组采用颈椎间孔椎体间融合术,比较两组手术指标、腰椎功能、手术疗效。结果A组切口长度、手术时间、住院时间及日常生活恢复时间均短于B组,差异有统计学意义(P<0.05);术后3个月,A组Oswestry功能障碍指数(ODI)评分低于B组,日本骨科协会(JOA)评分高于B组,差异有统计学意义(P<0.05);末次随访,A组优良率高于B组,差异有统计学意义(P<0.05)。结论经皮椎间孔镜椎间盘切除术治疗腰椎间盘突出症合并椎管狭窄症效果显著,能降低患者机体创伤程度,可明显缩短住院时间,经济适用,值得临床推广。Objective To investigate the effect of percutaneous transforaminal endoscopic discectomy and transforaminal lumbar interbody fusion in the treatment of lumbar disc herniation complicated with spinal stenosis.Methods 64 patients with lumbar disc herniation complicated with intervertebral stenosis treated in our hospital from April 2019 to April 2021 were selected as the research subjects,and they were divied into group A and group B according to random number table method,with 32 cases in each group.Group A was treated with percutaneous transforaminal endoscopic discectomy,and group B was treated with transforaminal lumbar interbody fusion.The surgical indexes,lumbar spine function and surgical efficacy were compared between the two groups.Results The incision length,operation time,hospital stay and recovery time of daily life in group A were shorter than those in group B,the difference was statistically significant(P<0.05).3 months after operation,the score of Oswestry dysfunction index(ODI)in group A was lower than that in group B,and the score of Japanese Orthopaedic Aassociation(JOA)in group A was higher than that in group B,the differences were statistically significant(P<0.05).At the last follow-up,the excellent rate in group A was higher than in group B,the difference was statistically significant(P<0.05).Conclusion Patients with lumbar disc herniation complicated with spinal stenosis are treated with percutaneous transforaminal endoscopic discectomy is effective,which can reduce the degree of trauma,and shorten the hospital stay,economic application,and is worthy of clinical promotion.

关 键 词：经皮椎间孔镜椎间盘切除术 颈椎间孔椎体间融合术 腰椎间盘突出合并椎管狭窄症 

分 类 号：R687.3[医药卫生—骨科学]