侧后路椎间孔镜下髓核摘除术治疗腰椎间盘突出症  

Lateral-posterior approach transforaminal endoscopic discectomy of nucleus pulposus in the treatment of lumbar disc herniation

作　　者：杨翔 YANG Xiang(SectionⅠ,Dept of Orthopaedics,the People′s Hospital of Ningguo City,Xuancheng,Anhui 242300,China)

机构地区：[1]宁国市人民医院骨一科,安徽宣城242300

出　　处：《临床骨科杂志》2023年第2期173-176,共4页Journal of Clinical Orthopaedics

摘　　要：目的 探讨侧后路椎间孔镜下髓核摘除术治疗腰椎间盘突出症的临床疗效。方法 将80例腰椎间盘突出症患者根据手术方法不同分为孔镜组(采用侧后路椎间孔镜下髓核摘除术治疗,42例)和开窗组(采用后正中入路椎板间开窗髓核摘除术治疗,38例)。比较两组手术时间、切口长度、术中出血量及JOA评分。结果 患者均获得随访,时间3~14个月。两组手术时间比较差异无统计学意义(P>0.05)。切口长度、术中出血量孔镜组均短(少)于开窗组(P<0.001)。术后3个月JOA评分两组均较术前明显改善(P<0.05),两组间比较差异无统计学意义(P>0.05)。结论 侧后路椎间孔镜下髓核摘除术治疗腰椎间盘突出症具有切口小、出血少等优点,且能达到同开放手术相同的直接减压效果。Objective To investigate the clinical efficacy of transforaminal endoscopic discectomy for nucleus pulposus via the lateral-posterior approach in the treatment of lumbar disc herniation(LDH).Methods Eighty patients with LDH were divided into the foraminoscopy group and fenestration group according to the surgery methods,42 cases of the foraminoscopy group were treated with transforaminal endoscopic discectomy of nucleus pulposus via the lateral-posterior approach,and 38 cases of the fenestration group were treated with discectomy of the nucleus pulposus with interlaminar fenestration via the posterior median approach.The surgery durations,incision lengths,intraoperative bleeding volume and JOA scores between both groups were compared.Results All the patients were followed up for 3~14 months.The surgery duration in both groups showed no statistically significant difference(P>0.05),but the incision length,and intraoperative bleeding volume were all shorter(smaller)in the foraminoscopy group than the fenestration group(P<0.001).At 3 months after surgery,JOA scores in two groups were significant improved than the preoperation(P<0.05),and there was no difference between two groups(P>0.05).Conclusions Transforaminal endoscopic discectomy for nucleus pulposus in the treatment of lumbar disc herniation via the lateral-posterior approach has the advantages of smaller incisions,less bleeding,and which can reach the same direct decompression effect of open operation.

关 键 词：椎间孔镜 髓核摘除术 腰椎间盘突出症 

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