经皮内窥镜联合Coflex棘突间动力重建系统在腰椎间盘突出症中的应用研究  

Application of Percutaneous Endoscope Combined with Coflex Interspinous Process Dynamic Reconstruction System in Lumbar Disc Herniation

作　　者：邵莉剑 

机构地区：[1]横店文荣医院骨科,浙江 金华

出　　处：《医学诊断》2020年第4期245-253,共9页Medical Diagnosis

摘　　要：目的:探究经皮内窥镜联合Coflex棘突间动力重建系统在腰椎间盘突出症中的应用效果。方法:本研究选取自2016年6月~2018年6月入我院脊柱外科的128例腰椎间盘患者,按照随机数字法进行分组,即联合组和单纯内镜组。联合组采用经皮内窥镜联合Coflex棘突间动力重建系统,单纯内镜组采用经皮内窥镜下腰椎间盘髓核摘除术,每个组又分成2个节段,即L4~L5和L5~S1节段。统计比较两组术前、术后以及末次随访时侧位X线片测得病变节段椎体间和相邻椎体间腹侧高度(ventral intervertebral space height, VH)、椎体间背侧高度(dorsal intervertebral space height, DH)、椎间孔高度(intervertebral foramen height, IFH),采用Oswestry功能障碍指数(ODI)及日本骨科协会(JOA)评分,疼痛视觉模拟评分(VAS)评价临床疗效。结果:1) 2组患者一般基准资料比较无统计学差异(P 】0.05)。2) 2组患者手术资料比较结果显示,联合组手术时间比单纯内镜组长(P 0.05);2组术后ODI,JOA评分和VAS评分比较有统计学差异(P 0.05);2组术后VH比较无统计学差异(P 】0.05);末次随访VH比较无统计学差异(P 】0.05)。2组术后和末次随访DH,IFH比较具有统计学差异(P 【0.05)。结论:经皮内窥镜联合Coflex棘突间动力重建系统对于微创治疗腰椎间盘突出症的患者具有良好的短期和长期效果。Objective: To explore the effect of percutaneous endoscope combined with Coflex interspinous process dynamic reconstruction system in lumbar disc herniation. Methods: From June 2016 to June 2018, 128 patients with lumbar intervertebral disc were divided into combined group and endoscope group according to the random number method. The combined group was treated with percutaneous endoscope combined with Coflex interspinous process dynamic reconstruction system, and the simple endoscopic group was treated with percutaneous endoscope discectomy of nucleus pulposus. Each group was divided into two segments: L4~L5 and L5~S1. Ventral intervertebral space height (VH), Dorsal intervertebral space height (DH) and Intervertebral foramen height (IFH) were conducted between the two groups before operation. After operation and at the last follow-up, Oswestry dysfunction index (ODI) and score of Japanese orthopedic association (JOA) were measured. Pain visual analogue score (VAS) was used to evaluate the clinical efficacy. Results: 1) There was no significant difference in general baseline data between the two groups (P >0.05). 2) The operative time of the combined group was longer than that of the group of endoscope alone (P 0.05). There was a significant difference in VAS score and ODI JOA score between the two groups after operation (P 0.05), and there was no significant difference in VH between the two groups (P >0.05), but there was no significant difference between the last follow-up group (P >0.05) and the last follow-up group (P <0.05). Conclusion: Percutaneous endoscopy combined with Coflex interspinous dynamic reconstruction system has a good short-term and long-term effect for minimally invasive treatment of lumbar disc herniation.

关 键 词：Coflex棘突间动力重建系统 腰椎间盘突出症 腰椎间盘髓核摘除术 青年 

分 类 号：R68[医药卫生—骨科学]