3种入路脊柱内镜下治疗腰椎间盘突出症患者的临床效果探讨  

Clinical Effect of Three Kinds of Spinal Endoscopy in the Treatment of Pa⁃tients with Lumbar Disc Herniation

作　　者：缪志锐 陈陆平 蔡学海 赖俊雄 黄光立 MIAO Zhirui;CHEN Luping;CAI Xuehai;LAI Junxiong;HUANG Guangli(Department of Orthopedics,Shanwei People's Hospital,Shanwei,Guangdong Province,516600 China)

机构地区：[1]汕尾市人民医院骨科,广东汕尾516600

出　　处：《中外医疗》2023年第1期87-90,共4页China & Foreign Medical Treatment

基　　金：汕尾市科技计划项目(2020C004)。

摘　　要：目的 研究3种入路脊柱内镜下治疗腰椎间盘突出症患者的临床效果。方法 回顾性分析2019年2月—2020年2月在汕尾市人民医院治疗的98例腰椎间盘突出症患者的临床资料,按治疗方式的不同分为A组(采取经皮后外侧椎间孔入路脊柱内镜下治疗,25例)、B组(采取经椎板间隙入路脊柱内镜下治疗,38例)和C组(采取后侧椎板间隙扩大成形或经椎板入路脊柱内镜下治疗,35例)。对比3组治疗前、治疗半年后的Oswestry功能障碍指数(ODI)、日本骨科协会腰椎评分(JOA)评分。结果 3组治疗半年后的ODI评分中A组(15.63±3.58)分、B组(16.52±3.21)分、C组(15.98±2.98)分均低于治疗前,而JOA评分中A组(23.26±2.01)分、B组(22.98±2.41)分、C组(22.48±2.14)分均高于治疗前,差异有统计学意义(P<0.05);3组治疗后的ODI、JOA评分相比,差异无统计学意义(P>0.05)。结论 3种入路脊柱内镜下治疗方法疗效相当,临床可根据患者的腰椎间盘突出情况采取合适的入路脊柱内镜下治疗,能有效改善病情,提高患者的腰椎功能。Objective To study the clinical effect of three kinds of spinal endoscopy in the treatment of patients with lumbar disc herniation.Methods The clinical data of ninety-eight patients with lumbar disc herniation treated in Shanwei People's Hospital from February 2019 to February 2020 were retrospectively analyzed.According to different treatment methods,they were divided into group A(25 cases underwent spinal endoscopy through percutaneous pos⁃terolateral foraminal approach),group B(38 cases underwent spinal endoscopy through interlaminal approach)and group C(35 cases underwent posterior interlaminal enlargement or spinal endoscopy through interlaminal approach).Oswestry disability index(ODI)and Japanese Orthopaedic Association Lumbar Spine Score(JOA)were compared in the three groups before treatment and six months after treatment.Results After half a year of treatment,ODI scores in group A(15.63±3.58)points,group B(16.52±3.21)points and group C(15.98±2.98)points were all lower than before treatment.The JOA scores in group A(23.26±2.01)points,group B(22.98±2.41)points and group C(22.48±2.14)points were higher than those before treatment,and the difference was statistically significant(P<0.05).There was no significant difference in ODI and JOA scores among the three groups after treatment(P>0.05).Conclusion The effi⁃cacy of the three approaches for endoscopic treatment of the spine is comparable.Clinically,the appropriate approach for endoscopic treatment of the spine can be adopted according to the situation of the patients with lumbar disc hernia⁃tion,which can effectively improve the condition and improve the lumbar function of the patients.

关 键 词：脊柱内镜下 经皮后外侧椎间孔入路 经椎板间隙入路 后侧椎板间隙扩大成形或经椎板入路 腰椎间盘突出症 ODI JOA 

分 类 号：R687[医药卫生—骨科学]