脊柱内镜在腰椎间盘突出症伴马尾神经冗余征术后临床疗效研究  

Clinical Efficacy of Spinal Endoscopy in Postoperative Treatment of Lumbar Disc Herniation with Redundant Nerve Roots Syndrome

作　　者：苟于炜 王琦琳 王越然 谢贤松 张映波[1] Gou Yuwei;Wang Qilin;Wang Yueran(Department of Orthopedics,Affiliated Hospital of North Sichuan Medical College,Nanchong,Shichuan 637000;Department of OrthopedicsⅢ,Bazhong Central Hospital,Bazhong,Shichuan 636600,China)

机构地区：[1]川北医学院附属医院骨科,四川南充637000 [2]巴中市中心医院骨三科,四川巴中636600

出　　处：《四川医学》2025年第3期284-289,共6页Sichuan Medical Journal

摘　　要：目的分析腰椎间盘突出症(LDH)伴马尾神经冗余征(RNRs)患者在脊柱内镜术后的临床效果。方法回顾性选取2021年10月至2023年5月我院骨科收治的82例LDH患者临床资料,并根据是否伴有RNRs进行分组,将有RNRs患者作为观察组,无RNRs患者作为对照组。两组均采用微创脊柱内镜下椎间盘摘除手术方式进行治疗,比较两组患者术前、术中及术后各项临床指标及临床疗效。结果观察组38例,对照组44例。两组患者性别、年龄、BMI差异无统计学意义(P>0.05);观察组患者的住院天数及病程均长于对照组,差异有统计学意义(P<0.05)。两组患者的手术节段差异无统计学意义(P>0.05),但观察组的手术时间及术中出血量均高于对照组,差异有统计学意义(P<0.05)。术前,观察组的巴氏指数(BI)低于对照组,改良腰椎Oswestry功能障碍评分(MODI)高于对照组,差异均有统计学意义(P<0.05);而两组的腰腿视觉模拟疼痛评分(VAS)差异无统计学意义(P>0.05)。术后,两组患者的BI、MODI及VAS评分均较术前改善,但观察组的术后BI及VAS评分低于对照组,术后MODI评分高于对照组,差异有统计学意义(P<0.05)。两组患者术前下肢肌力情况及肛门、会阴区麻木情况差异有统计学意义(P<0.05),术后,这些指标在两组患者中均有所改善,但观察组的改善程度低于对照组,差异有统计学意义(P<0.05)。结论伴RNRs的LDH患者行脊柱内镜椎间盘摘除术后各项指标恢复较不伴RNRs的LDH患者恢复差,RNRs可作为预测脊柱内镜椎间盘摘除术后临床效果的潜力指标。Objective To analyze clinical outcome of patients with lumbar disc herniation with redundant nerve roots syndrome after spinal endoscopy.Methods From October 2021 to May 2023,a retrospective selection of clinical data from 82 patients with lumbar disc herniation was conducted.Patients were divided into groups based on whether they had redundant nerve roots syndrome.Patients with redundant nerve roots syndrome were selected as observation group(OG),while patients without redundant nerve roots syndrome were selected as control group(CG).Both groups were treated with minimally invasive endoscopic discectomy,and clinical indicators and efficacy before,during,and after surgery were compared.Results There were 38 cases in OG and 44 cases in CG.There was no statistically significant difference in gender,age,and BMI in general data comparison(P>0.05).Hospital stay and disease course of patients in OG were longer than those in CG with statistically significant differences(P<0.05).There was no statistically significant difference in surgical segments(P>0.05),but operation time and intraoperative blood loss in OG were higher than those in CG,with statistically significant differences(P<0.05).Before surgery,Barthel Index(BI)of OG was lower,and the Modified Oswestry Disability Index(MODI)was higher compared to CG,both with statistically significant differences(P<0.05).However,there was no statistically significant difference in visual analog scale(VAS)score for lumbar and leg pain(P>0.05).Postoperatively,BI,MODI,and VAS scores of both groups improved compared to preoperative levels.However,the postoperative BI and VAS scores of OG were lower than those of CG,while the postoperative MODI score was higher,with statistically significant differences(P<0.05).There were statistically significant differences in preoperative lower limb muscle strength and perianal/perineal numbness(P<0.05).Postoperatively,these indicators improved in both groups,but the degree of improvement in OG was inferior to that in CG,with statistically signifi

关 键 词：马尾神经冗余征 脊柱微创 脊柱内镜 临床疗效 

分 类 号：R681.53[医药卫生—骨科学]