经皮椎间孔镜髓核摘除术对腰椎间盘突出症患者脊柱稳定性的影响研究  

Study on the effect of percutaneous transforaminal endoscopic discectomy on spinal stability of patients with lumbar disc herniation

作　　者：金威宏 金剑飞 JIN Wei-hong;JIN Jian-fei(Department of orthopedics,Fuliang Orthopedic Hospital,Jingdezhen 333000,China)

机构地区：[1]浮梁正骨医院骨科,333000

出　　处：《中国实用医药》2024年第19期55-58,共4页China Practical Medicine

摘　　要：目的 探讨经皮椎间孔镜髓核摘除术对腰椎间盘突出症(LDH)患者脊柱稳定性的影响。方法 150例腰椎间盘突出症患者,随机分为对照组及观察组,每组75例。对照组使用椎板开窗髓核摘除术,观察组使用经皮椎间孔镜髓核摘除术。对比两组的手术指标、脊柱稳定性及腰部功能指标、临床疗效、并发症发生情况。结果 观察组手术时间(58.36±6.11)min、切口长度(0.79±0.20)cm、术后卧床时间(2.72±0.68)d、住院时间(5.23±0.70)d均短于对照组的(82.43±8.75)min、(4.83±0.69)cm、(4.92±1.04)d、(10.04±2.45)d,术中出血量(15.76±2.53)ml少于对照组的(67.25±10.82)ml(P<0.05)。观察组术后3个月的腰椎曲度(1.99±0.25)cm、腰椎前凸角度(44.29±1.56)°、腰骨倾斜角(33.23±1.58)°均大于对照组的(1.80±0.28)cm、(41.73±1.45)°、(31.02±1.48)°, Oswestry功能障碍指数(ODI)评分(3.91±1.02)分低于对照组的(7.15±1.53)分(P<0.05)。观察组优良率为96.00%,明显高于对照组的78.67%(P<0.05)。观察组并发症发生率为4.00%,明显低于对照组的17.33%(P<0.05)。结论 经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症的疗效显著,能提高脊柱稳定性,改善腰部功能,且并发症发生率低,安全性好。Objective To explore the effect of percutaneous transforaminal endoscopic discectomy on spinal stability of patients with lumbar disc herniation(LDH).Methods 150 patients with lumbar disc herniation were randomly divided into a control group and an observation group,with 75 cases in each group.The control group underwent fenestration discectomy,and the observation group underwent percutaneous transforaminal endoscopic discectomy.The surgical indicators,spinal stability and lumbar function indicators,clinical efficacy and complications were compared between the two groups.Results The observation group had operation time of(58.36±6.11)min,incision length of(0.79±0.20)cm,postoperative bed time of(2.72±0.68)d and hospital stay of(5.23±0.70)d,which were all shorter than(82.43±8.75)min,(4.83±0.69)cm,(4.92±1.04)d and(10.04±2.45)d in the control group;the intraoperative blood loss of(67.25±10.82)ml in the observation group was less than(15.76±2.53)ml in the control group(P<0.05).3 months after surgery,the observation group had lumbar curvature of(1.99±0.25)cm,lumbar lordosis angle of(44.29±1.56)°and lumbar tilt angle of(33.23±1.58)°,which were higher than(1.80±0.28)cm,(41.73±1.45)°and(31.02±1.48)°in the control group;the Oswestry disability index(ODI)score of(3.91±1.02)points in the observation group was lower than(7.15±1.53)points in the control group(P<0.05).The excellent rate of 96.00%in the observation group was significantly higher than 78.67%in the control group(P<0.05).The incidence of complications in the observation group was 4.00%,which was significantly lower than 17.33%in the control group(P<0.05).Conclusion Percutaneous transforaminal endoscopic discectomy is effective for the treatment of lumbar disc herniation,which can improve spinal stability for the treatment of lumbar disc herniation,improve lumbar function,and has a low complication rate and good safety.

关 键 词：腰椎间盘突出症 经皮椎间孔镜髓核摘除术 疗效 脊柱稳定性 

分 类 号：R687.3[医药卫生—骨科学]