腰椎间盘突出症临床分型与经皮椎间孔镜手术疗效关系研究  

Study on the Relationship Between Clinical Staging of Lumbar Disc Herniation and the Efficacy of Percutaneous Intervertebral Foraminoscopic Surgery

作　　者：豆志文 李震[1] 左伟[1] Dou Zhiwen;Li Zhen;Zuo Wei(Department of Orthopaedic Ward One,Anyang Third People's Hospital,Anyang,Henan,455000,China)

机构地区：[1]安阳市第三人民医院骨科一病区,河南安阳455000

出　　处：《黑龙江医学》2024年第10期1177-1179,共3页Heilongjiang Medical Journal

摘　　要：目的:探究腰椎间盘突出症(LDH)临床分型与经皮椎间孔镜手术疗效关系。方法:选取2021年11月—2022年11月安阳市第三人民医院接受经皮椎间孔镜手术治疗的125例不同临床分型LDH患者作为研究对象。比较不同临床分型LDH患者手术相关指标评估手术安全性;选用视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)、日本骨科协会评估治疗分数(JOA)比较不同分型患者手术疗效。结果:在经皮椎间孔镜手术治疗下,侧弯型患者手术时间、术中出血量、住院时间明显低于其他分型的患者,足下垂型患者手术时间、术中出血量、住院时间明显高于其他分型的患者;经皮椎间孔镜手术后1个月随访,不同临床分型LDH患者VAS、ODI及JOA评分均较治疗前显著改善。结论:对不同临床分型LDH患者实施经皮椎间孔镜手术治疗疗效较好,患者术后疼痛逐渐减轻、腰椎功能和神经功能恢复良好,且所有患者手术时间、出血量及住院时间指标良好,但其中侧弯型患者临床效果最佳、足下垂型患者疗效稍差。Objective: To investigate the relationship between clinical staging of lumbar disc herniation and the efficacy of percutaneous foraminotomy. Methods: 125 patients with different clinical staging of lumbar disc herniation who underwent percutaneous laminectomy in the hospital from November 2021 to November 2022 were selected as the study subjects. The safety of surgery was evaluated by comparing the surgical indexes of patients with different clinical subtypes of LDH;the visual analog scale(VAS), Oswestry disability index(ODI), and the Japanese Orthopaedic Association Scores(JOA) were used to compare the surgical outcomes of patients with different staging. Results: Under percutaneous foraminoscopic treatment, the operation time,intraoperative bleeding, hospitalization time in patients with scoliosis were significantly lower than other subtypes. The operation time, intraoperative blood loss, and length of stay in patients with foot drop were significantly higher than those with other types. At the 1-month follow-up after percutaneous laminectomy, the VAS, ODI and JOA scores of patients with different clinical subtypes of LDH were significantly higher than those before treatment. Conclusion: Percutaneous intervertebral foraminoscopic for lumbar disc herniation with different clinical types is effective, and the postoperative pain symptoms were gradually reduced and the recovery of lumbar spine function and neurological function was good. All patients had good indicators of operative time, bleeding and hospitalization time. However, the clinical effect of patients with lateral bending type is the best, and that of patients with foot drop type is slightly worse.

关 键 词：腰椎间盘突出症 临床分型 经皮椎间孔镜 

分 类 号：R681.52[医药卫生—骨科学]