经皮椎间孔镜髓核摘除术对L4~5节段腰椎间盘突出症患者腰部活动度及并发症的影响  

Effect of Percutaneous Foraminoscopic Nucleus Pulposus Extraction on Lumbar Motion and Complications in Patients with Lumbar Disc Herniation at L4-5

作　　者：花家香 凌蒙 郭培杰 戴俊 HUA Jiaxiang;LING Meng;GUO Peijie;DAI Jun(The Ninth People's Hospital of Jiujiang City,Jiangxi Province,Jiujiang 332100,China)

机构地区：[1]江西省九江市第九人民医院,江西九江332100

出　　处：《中国医学创新》2023年第17期59-62,共4页Medical Innovation of China

摘　　要：目的:探讨经皮椎间孔镜髓核摘除术对L4~5节段腰椎间盘突出症患者腰部活动度及并发症的影响。方法:选取2019年1月-2022年1月九江市第九人民医院收治的86例L4~5节段腰椎间盘突出症患者,按照随机数字表法将患者分为常规组与试验组,各43例。常规组给予椎板开窗髓核摘除术,试验组给予经皮椎间孔镜髓核摘除术。比较两组腰椎功能[日本骨科协会腰椎功能(JOA)评分、Oswestry功能障碍指数(ODI)评分]、腰部活动度及并发症发生情况。结果:两组手术前腰椎功能评分比较,差异均无统计学意义(P<0.05);两组术后1个月JOA评分均高于手术前,试验组高于常规组(P<0.05);两组术后1个月ODI评分均低于手术前,试验组低于常规组(P<0.05)。两组手术前前屈、后伸腰部活动度比较,差异均无统计学意义(P>0.05);两组术后1个月前屈、后伸腰部活动度均高于手术前,且试验组均高于常规组(P<0.05)。试验组并发症发生率低于常规组(χ^(2)=4.692,P=0.030)。结论:经皮椎间孔镜髓核摘除术治疗L4~5节段腰椎间盘突出症患者,可明显改善腰椎功能,改善腰部活动度,降低并发症。Objective:To investigate the effect of percutaneous foraminoscopic nucleus pulposus extraction on lumbar motion and complications in patients with lumbar disc herniation at L4-5.Method:A total of 86 patients with L4-5 lumbar disc herniation admitted to the Ninth People's Hospital of Jiujiang City from January 2019 to January 2022 were selected and divided into the conventional group and the experimental group according to random number table method,with 43 cases in each group.The conventional group underwent fenestration of laminae nucleus pulposus discectomy and the experimental group underwent percutaneous foraminoscopic nucleus pulposus extraction.Lumbar function[Japanese orthopaedic association lumbar function(JOA)score],Oswestry disability index(ODI)score,lumbar motion and incidence of complications were compared between the two groups.Result:There was no significant difference in lumbar function scores between the two groups before operation(P<0.05);1 month after operation,JOA scores in both groups were higher than those before operation,that in experimental group was higher than that in conventional group(P<0.05);1 month after operation,ODI scores in both groups were lower than those before operation,that in experimental group was lower than that in conventional group(P<0.05).There was no significant difference in the range of motion of flexion and lumbar extension before operation between the two groups(P>0.05);the range of flexion and lumbar extension in both groups were higher than those before operation at 1 month after operation,and those in experimental group were higher than those in the conventional group(P<0.05).The complication rate in experimental group was lower than that in conventional group(χ^(2)=4.692,P=0.030).Conclusion:The treatment of L4-5 lumbar disc herniation by percutaneous foraminoscopic nucleus pulposus extraction can significantly improve the function of lumbar spine,improve lumbar motion and reduce complications.

关 键 词：椎板开窗髓核摘除术 腰椎间盘突出症 腰椎功能 经皮椎间孔镜髓核摘除术 

分 类 号：R687.3[医药卫生—骨科学]