经皮椎间孔镜手术与半椎板切除减压椎间融合内固定术治疗重度脱出型腰椎间盘突出症的临床效果比较  

Comparison of clinical effects of percutaneous transforaminal endoscopic surgery and semi-laminectomy decompression interbody fusion and internal fixation in the treatment of severe prolapsed lumbar disc herniation

作　　者：梁青福 陈丹祎[1] 陈博 LIANG Qingfu;CHEN Danyi;CHEN Bo(Spine Surgery Department,Shangluo Central Hospital,Shangluo 726099,China)

机构地区：[1]商洛市中心医院脊柱外科,陕西商洛726099

出　　处：《临床医学研究与实践》2023年第23期53-56,共4页Clinical Research and Practice

摘　　要：目的探究经皮椎间孔镜手术与半椎板切除减压椎间融合内固定术对重度脱出型腰椎间盘突出症患者的疼痛程度、功能障碍及炎症状况的影响。方法根据手术方式不同将2019年3月至2021年3月本院收治的120例重度脱出型腰椎间盘突出症患者分为对照组(n=60,半椎板切除减压椎间融合内固定术)和试验组(n=60,经皮椎间孔镜手术)。比较两组的治疗效果。结果试验组的术中出血量少于对照组,伤口小于对照组,术后卧床至下床活动时间、住院时间均短于对照组(P<0.05)。术后1周,试验组的视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)评分低于对照组,Lehmann腰椎功能量表评分高于对照组(P<0.05)。术后24 h,两组的肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)以及白细胞介素-6(IL-6)水平均升高,但试验组低于对照组(P<0.05)。结论较半椎板切除减压椎间融合内固定术,经皮椎间孔镜手术对重度脱出型腰椎间盘突出症患者的疗效更佳,能更有效地改善患者的术后疼痛程度、功能障碍以及炎症状况。Objective To explore the effects of percutaneous transforaminal endoscopic surgery and semi-laminectomy decompression interbody fusion and internal fixation on pain degree,dysfunction and inflammation in patients with severe prolapsed lumbar disc herniation.Methods According to different surgical methods,120 patients with severe prolapsed lumbar disc herniation admitted in our hospital from March 2019 to March 2021 were divided into control group(n=60,semi-laminectomy decompression interbody fusion and internal fixation)and experimental group(n=60,percutaneous transforaminal endoscopic surgery).The therapeutic effects of the two groups were compared.Results The intraoperative blood loss in the experimental group was less than that in the control group,the wound was smaller than that in the control group,the time from bed rest to getting out of bed and hospitalization time were shorter than those in the control group(P<0.05).At 1 week after surgery,the scores of Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)in the experimental group were lower than those in the control group,and the score of Lehmann Lumbar Function Scale was higher than that in the control group(P<0.05).At 24 h after surgery,the levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4)and interleukin-6(IL-6)in the two groups increased,but those in the experimental group were lower than the control group(P<0.05).Conclusion Compared with semi-laminectomy decompression interbody fusion and internal fixation,percutaneous transforaminal endoscopic surgery is more effective in patients with severe prolapsed lumbar disc herniation,and can more effectively improve postoperative pain degree,dysfunction and inflammation.

关 键 词：经皮椎间孔镜手术 半椎板切除减压椎间融合内固定术 重度脱出型腰椎间盘突出症 

分 类 号：R681.5[医药卫生—骨科学]