探讨侧后方入路、椎板间隙入路经皮椎间孔镜治疗中央型腰椎间盘突出症的临床效果  

Clinical Effect of Lateral-posterior Approach and Interlaminar Approach with Percutaneous Foraminoscopy in the Treatment of Central Lumbar Disc Herniation

作　　者：罗林峰 庄沙斌 屈锡亮 黄雄飞 LUO Lin-feng;ZHUANG Sha-bin;QU Xi-liang(Department of Orthopedics,Dongguan Hospital of Traditional Chinese Medicine,Dongguan,Guangdong,523000,China)

机构地区：[1]东莞市中医院骨科,广东东莞523000

出　　处：《黑龙江医学》2023年第4期426-428,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨中央型腰椎间盘突出症(central lumbar disc herniation,CLDH)应用经皮椎间孔镜治疗时不同入路方式(侧后方与椎板间隙)的临床效果。方法:选取2015年12月—2020年12月东莞市中医院收治的106例CLDH患者作为研究对象,所有患者均接受经皮椎间孔镜治疗,根据入路方式不同分为两组,每组各53例。对照组予以侧后方入路,观察组予以椎板间隙入路。两组患者均术后随访3个月以上,比较两组患者手术时间、手术出血量、住院时间、疗效以及术前与术后3个月疼痛VAS评分、腰椎功能情况。结果:观察组手术时间短于短于对照组,手术出血量低于对照组,住院时间少于对照组,差异有统计学意义(t=2.995、2.604、3.004,P<0.05);术后3个月,观察组疼痛VAS评分明显低于对照组,差异有统计学意义(t=2.854,P<0.05)。随访3个月,两组患者评价疗效比较,差异无统计学意义(χ^(2)=0.997,P>0.05)。结论:CLDH患者应用经皮椎间孔镜治疗,不同的入路取得的疗效相当,而且对腰椎功能影响并无明显差异,但是经椎板间隙入路相比侧后方入路,可显著减少手术时间与手术出血量,缩短住院时间,缓解术后疼痛。Objective:To investigate the clinical effects of different access modalities(lateral posterior versus laminar space) in the application of percutaneous lumbar disc herniation(CLDH).Methods:106 patients with CLDH admitted to the hospital from December 2015 to December 2020 were selected for the study, and all patients received percutaneous laminectomy, and were divided into two groups according to the different access methods, with 53 cases in each group. The control group was given a lateralposterior approach and the observation group was given an interlaminar approach. Patients in both groups were followed up for more than 3 months after surgery, and the operative time, operative bleeding, hospital stay, efficacy, and pain VAS score and lumbar spine function before and 3 months after surgery were compared between the two groups.Results:The observation group had shorter operative time than the control group, lower operative bleeding than the control group, and less hospital stay than the control group, with statistically significant differences(t=2.995, 2.604, 3.004, P<0.05). At 3 months after surgery, the pain VAS score in the observation group was significantly lower than that in the control group, and the difference was statistically significant(t=2.854, P<0.05). At 3 months of follow-up, there was no statistically significant difference between the two groups in terms of the evaluated efficacy(χ^(2)=0.997, P>0.05).Conclusion:In patients with CLDH treated with percutaneous laminectomy, the different approaches achieved comparable efficacy and did not significantly differ in their effects on lumbar spine function, but the trans-laminar approach significantly reduced operative time and surgical bleeding, shortened hospital stay, and relieved postoperative pain compared with the lateral-posterior approach.

关 键 词：中央型腰椎间盘突出症 侧后方 椎板间隙 不同入路 经皮椎间孔镜治疗 腰椎功能 

分 类 号：R657.4[医药卫生—外科学]