神经根封闭定位后椎间孔镜治疗多节段腰椎间盘突出症疗效分析  

Treatment of multi-level lumbar disc herniation with nerve root closure and posterior foraminoscopy

作　　者：胡斌 李力[1] 谢涛[1] 孔祥安[1] HU Bin;LI Li;XIE Tao;KONG Xiang-an(Department of Orthopedics,the Second People's Hospital of Hefei,Hefei Hospital Affiliated to Anhui Medical University,Hefei,Anhui 230011,China)

机构地区：[1]合肥市第二人民医院(安徽医科大学附属合肥医院)骨科,安徽合肥230011

出　　处：《颈腰痛杂志》2024年第5期929-932,940,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：合肥市第七周期医学重点专科资助。

摘　　要：目的分析神经根封闭定位后椎间孔镜治疗多节段腰椎间盘突出症的疗效。方法选取2018年1月至2022年4月在本院就诊的90例多节段腰椎间盘突出症患者,通过神经根封闭定位责任节段椎间盘,而后采用椎间孔镜治疗。分别在术前、术后2周、术后3个月、术后6个月、术后12个月评估患者的疼痛程度、腰椎功能恢复情况。记录随访期间患者的并发症发生情况。结果90例患者在神经根封闭过程中均无神经根损伤发生,与术前相比,术后2周、术后3个月、术后6个月及术后12个月,患者的下腰及腿部视觉模拟评分(VAS)明显降低(P<0.05);术后3个月、术后6个月及术后12个月,患者的Oswestry功能障碍指数(ODI)明显降低,日本骨科学会评分(JOA)明显升高(P<0.05)。术后12个月时,患者的临床疗效明显升高(P<0.05)。随访期间,90例中发生4例(4.44%)并发症,其余无相关并发症发生。结论神经根封闭定位后椎间孔镜治疗多节段腰椎间盘突出症,具有明确责任节段、疗效显著的优势,还能明显改善患者的疼痛程度,并改善腰椎功能,减少并发症发生,值得临床推广应用。Objective To analyze the curative effect of posterior foraminoscope with closed nerve root in the treatment of multi-segment lumbar disc herniation.Methods 90 patients with multi-segment lumbar disc herniation were selected from January 2018 to April 2022,and the responsible segment discs were located by nerve root closure.Pain degree and lumbar function recovery were evaluated before surgery,2 weeks after surgery,3 months after surgery,6 months after surgery,and 12 months after surgery.Complications were recorded during follow-up.Results No nerve root injury occurred in 90 patients with segmental lumbar disc herniation during nerve root closure.Visual analogue scores(VAS)of the lower back and legs were significantly lower than those of the patients at 2 weeks,3 months,6 months and 12 months after surgery(P<0.05).The Oswestry Disability Index(ODI)was significantly lower and the Japanese Orthopaedic Society(JOA)score was significantly higher at 3,6 and 12 months after surgery(P<0.05).At 12 months after operation,the clinical efficacy of the patient was significantly higher than before(P<0.05).During the follow-up period,a total of 4(4.44%)of the 90 patients had complications,and the rest had no related complications.Conclusion The treatment of multi-segmental lumbar disc herniation with nerve root closure and posterior foraminoscopy has the advantages of identifying the responsible segment and significant efficacy.It can also significantly improve the pain degree of patients,improve lumbar function and reduce complications,and is worthy of clinical application.

关 键 词：神经根封闭定位 椎间孔镜 腰椎间盘突出症 

分 类 号：R681.5[医药卫生—骨科学]