经皮脊柱内镜经椎板入路手术治疗腰椎不稳伴腰椎间盘突出症患者的临床疗效  

Clinical Effect of Percutaneous Spinal Endoscopic Translaminar Approach in the Treatment of Lumbar Instability with Lumbar Disc Herniation

作　　者：张冰 马航 ZHANG Bing;MA Hang(Department of Spine Surgery,Xianyang Central Hospital,Xianyang Shaanxi 712000)

机构地区：[1]咸阳市中心医院脊柱外科,陕西咸阳712000

出　　处：《医学临床研究》2024年第11期1726-1728,1732,共4页Journal of Clinical Research

摘　　要：【目的】探讨经皮脊柱内镜经椎板入路手术治疗腰椎不稳伴腰椎间盘突出症患者的临床疗效。【方法】回顾性分析2019年5月至2022年5月在本院行经皮脊柱内镜经椎板入路手术的164例腰椎不稳伴腰椎间盘突出症患者(A组),另选取同期在本院行常规开放手术的97例患者(B组)。比较两组患者术前及术后的腰腿疼痛情况[视觉模拟评分法(visual analogue scale,VAS)]、腰椎功能障碍程度[Oswestry功能障碍指数(ODI)]及治疗效果、并发症发生情况。【结果】两组术前腰腿痛VAS评分及ODI评分比较,差异无统计学意义(P>0.05)。两组术后1 d、术后1个月、术后3个月的腰腿痛VAS评分及ODI评分,术后12个月ODI评分比较,差异有统计学意义(P<0.05),两组术后12个月腰腿痛VAS评分比较,差异均无统计学意义(P>0.05);A组术后1 d、术后1个月、术后3个月的腰腿痛VAS评分及ODI评分,术后12个月的ODI评分均低于B组。术后12个月,A组疗效优于B组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】相对于常规开放手术,经皮脊柱内镜经椎板入路治疗腰椎不稳伴腰椎间盘突出症患者,临床疗效显著,可改善患者疼痛程度和腰椎康复效果,且安全性较好。【Objective】To investigate the clinical effect of percutaneous spinal endoscopic translaminar approach in the treatment of lumbar instability with lumbar disc herniation.【Methods】A retrospective analysis was performed on 164 patients with lumbar instability with lumbar disc herniation(group A)who underwent percutaneous spinal endoscopic translaminectomy in our hospital from May 2019 to May 2022,and 97 patients(group B)who underwent routine open surgery in our hospital during the same period.The preoperative and postoperative lumbar pain[visual analogue scale(VAS)],the degree of lumbar dysfunction[Oswestry Disability Index(ODI)],the therapeutic effect and the incidence of complications were compared between the two groups.【Results】There was no significant difference in preoperative VAS and ODI scores between the two groups(P>0.05).VAS scores and ODI scores of back and leg pain 1 d,1 month and 3 months after surgery and ODI scores of 12 months after surgery between the two groups had statistical significance(P<0.05),while VAS scores of back and leg pain 12 months after surgery had no statistical significance between the two groups(P>0.05).VAS scores and ODI scores in the group A were lower than those in the group B at 1 day,1 month and 3 months after surgery,and ODI scores at 12 months after surgery.12 months after operation,the curative effect of the group A was better than that of the group B(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).【Conclusion】Compared with conventional open surgery,percutaneous spinal endoscopic translaminar approach for the treatment of patients with lumbar instability and lumbar disc herniation has significant clinical efficacy,can improve the pain degree of patients and lumbar rehabilitation effect,and has good safety.

关 键 词：腰椎/外科学 椎间盘移位/并发症 椎间盘移位/外科学 椎间盘切除术 经皮 治疗结果 

分 类 号：R681.53[医药卫生—骨科学]