经皮椎间孔镜下椎间盘切除术对治疗改良经椎间孔腰椎椎体间融合术后相邻节段病变的疗效与安全性  

Research of efficacy and security of percutaneous transforaminal endoscopic discectomy in the treatment of adjacent segment disease after modified transforaminal lumbar interbody fusion

作　　者：陆宣宇 袁硕[1] 藏磊[1] 梅语奇 范宁[1] 杜鹏[1] Lu Xuanyu;Yuan Shuo;Zang Lei;Mei Yuqi;Fan Ning;Du Peng(Department of Orthopedics,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院骨科,100043

出　　处：《骨科临床与研究杂志》2024年第3期145-150,共6页Journal Of Clinical Orthopedics And Research

基　　金：北京市自然科学基金(202311-202612)。

摘　　要：目的探讨经皮椎间孔镜下椎间盘切除术对治疗改良经椎间孔腰椎椎体间融合术后相邻节段病变的临床疗效与安全性。方法选取在2016年7月至2022年7月于首都医科大学附属北京朝阳医院骨科接受了经皮椎间孔镜下椎间盘切除术(PTED)的45例改良经椎间孔腰椎椎体间融合术后相邻节段病变(ASDis)患者资料进行回顾性研究。使用背部疼痛视觉模拟量表(VAS-BP)和腿部疼痛视觉模拟量表(VAS-LP)以及Oswestry残疾指数(ODI)评估患者术前、术后即刻、术后3、12个月以及最终随访时的临床结果。根据改良MacNab评分对患者治疗效果进行评估。结果与术前相比,患者的VAS-BP、VAS-LP及ODI评分均有显著改善(P<0.001),88.89%(40/45)的患者在最终随访时的改良MacNab评分为优或良。患者在术后即刻观察到临床症状改善,临床评分在术后随访期间保持稳定。患者术中及术后均未出现严重并发症。结论PTED是治疗邻近节段病变有效且安全的手术方式,具有创伤小,恢复快的优势。Objective To investigate the clinical efficacy and safety of percutaneous transforaminal endoscopic discectomy for adjacent segment disease after modified transforaminal lumbar interbody fusion.Methods A total of 45 patients who underwent percutaneous transforaminal endoscopic lumbar discectomy(PTED)in Department of Orthopedics,Beijing Chaoyang Hospital,Capital Medical University for treating adjacent segment disease(ASDis)in July 2016 and July 2022 were selected for the retrospective study.The back pain visual analog scale(VAS-BP),leg pain visual analog scale(VAS-LP),and Oswestry disability index(ODI)were used to assess the level of clinical symptoms preoperatively,postoperatively immediately,3 months and 12 months after surgery,and at the final follow-up,respectively.The treatment effect was evaluated according to the modified MacNab criteria.Results Compared with preoperative scores,the scores of VAS-BP,VAS-LP and ODI were significantly improved(P<0.001).88.9%(40/45)of the patients were rated as excellent or good according to modified MacNab criteria at the final follow-up.Clinical improvement was observed in all patients immediately after surgery.The scores remained stable during the following postoperative follow-up.No severe complications occurred during and after the operation.Conclusion With the advantages of minimal trauma and rapid recovery,PTED is an effective and safe treatment for patients with ASDis.

关 键 词：经皮经椎间孔镜下椎间盘切除术 邻近节段退变 腰椎间盘突出 临床疗效 

分 类 号：R681.5[医药卫生—骨科学]