经皮椎间孔镜髓核摘除术联合十字交叉纤维环缝合术治疗腰椎间盘突出症的临床效果  

Clinical efficacy of percutaneous transforaminal endoscopic discectomy combined with crossed annular suture in the treatment of lumbar disc herniation

作　　者：殷鹤 张长江 闫鹏 王瑞博 YIN He;ZHANG Changjiang;YAN Peng;WANG Ruibo(Department of OrthopedicsⅡ,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第五附属医院骨二科,河南郑州450000

出　　处：《医药前沿》2025年第9期35-39,共5页Journal of Frontiers of Medicine

基　　金：河南省医学科技攻关计划项目(LHGJ20220566)。

摘　　要：目的探讨经皮椎间孔镜髓核摘除术(PTED)联合十字交叉纤维环缝合术治疗腰椎间盘突出症(LDH)的临床效果。方法回顾性分析2017年1月—2022年12月在郑州大学第五附属医院因单节段LDH行手术治疗的363例患者,其中180例采用PTED联合普通单针纤维环缝合术治疗的患者纳入对照组,183例采用PTED联合十字交叉纤维环缝合术治疗的患者纳入观察组。比较两组患者住院时间、视觉模拟评分法(VAS)评分、功能障碍指数(ODI)、椎间隙高度、优良率、复发率和再次手术率。结果观察组住院时间短于对照组,差异有统计学意义(P<0.05);术后3、12个月,观察组ODI指数、VAS评分低于对照组,椎间隙高度高于对照组,差异有统计学意义(P<0.05);术后12个月,观察组优良率高于对照组,复发率和再次手术率低于对照组,差异有统计学意义(P<0.05)。结论PTED联合十字交叉维环缝合术治疗LDH,能够明显改善患者腰腿部疼痛和腰椎功能,有效减少术后复发并降低再手术率。Objective To investigate the clinical efficacy of percutaneous transforaminal endoscopic discectomy(PTED)combined with crossed annular suture in the treatment of lumbar disc herniation(LDH).Methods A retrospective analysis was conducted on 363 patients who underwent surgery for single-segment LDH at The Fifth Affiliated Hospital of Zhengzhou University from January 2017 to December 2022.Among them,180 patients who underwent PTED combined with conventional single-needle annular suture were included in the control group,while 183 patients who underwent PTED combined with crossed annular suture were included in the observation group.The two groups were compared in terms of hospital stay,Visual Analogue Scale(VAS)score,Oswestry Disability Index(ODI),intervertebral space height,excellent and good rate,recurrence rate,and reoperation rate.Results The observation group had a shorter hospital stay than the control group,with statistically significant differences(P<0.05);at 3 and 12 months postoperatively,the ODI index and VAS score in the observation group were lower than those in the control group,while the intervertebral space height was higher,with statistically significant differences(P<0.05);at 12 months postoperatively,the excellent and good rate in the observation group was higher than that in the control group,and the recurrence rate and reoperation rate were lower,with statistically significant differences(P<0.05).Conclusions PTED combined with crossed annular suture in the treatment of LDH can significantly improve patients'low back and leg pain and lumbar function,effectively reduce postoperative recurrence,and lower the reoperation rate.

关 键 词：椎间孔镜 髓核摘除术 十字交叉纤维环缝合术 单针简单纤维环缝合术 腰椎间盘突出症 

分 类 号：R681[医药卫生—骨科学]