摘要
[目的]对于治疗青少年腰椎间盘突出症（LDH）的经皮椎间孔镜技术与传统椎板间开窗髓核摘除术这两种不同外科术式进行比较。[方法]对本院2011~2014年23例青少年LDH患者临床资料进行回顾性分析,其中采用TESSYS技术行经皮椎间孔镜下髓核摘除术（PTED）组13例,传统椎板间开窗髓核摘除术组10例。观察两组切口长度、手术时间、术后下床活动时间、住院时间;记录两组患者术前、后红细胞压积（Hct）,并利用Gross循环血量线性方程,计算总失血量;根据患者术前、后下肢痛VAS评分及术后改良Mac Nab标准评分进行临床疗效分析。[结果]23例患者均获得随访,随访时间10~18个月,平均13.7个月。两组术后3 d,1、3个月及末次随访时VAS评分与术前相比均明显降低,差异有统计学意义（P〈0.05）,组间比较差异无统计学意义（P〉0.05）;按改良Mac Nab标准,末次随访时PTED组优10例,良2例,可1例,优良率为92.3%;开窗术组优8例,良1例,可1例,优良率为90.0%,两组间比较差异无统计学意义（P〉0.05）,但PTED组在手术时间、切口长度、总失血量、术后下床时间、住院时间方面优于开窗组（P〈0.05）。[结论]PTED治疗青少年LDH疗效与传统椎板间开窗术相当,但PTED具有创伤小、出血少、下床活动早、术后恢复快等优点,是治疗青少年LDH的一种良好术式。
[Objective] To compare the clinical results of percutaneous transforaminal endoscopic discectomy and conventional discectomy in treating adolescents lumbar disc herniation. [Methods] A total of 23 cases from 2011 to 2014 were retrospectively enrolled in this study. Thirteen patients received percutaneous transforaminal endoscopic discetomy（ PTED） using transforaminal endoscopic spine system（ TESSYS）. The other 10 were treated by conventional discectomy. Length of the incision,surgery time,in- bed time and hospital time were observed and recorded respectively. We also recorded hematocrit values before and after surgery to calculate the total blood loss volume in each patient with the Gross formula. The results were evaluated according to pre- and post- operative low limb pain visual analogue scale（ VAS）. The modified Mac Nab score was also used after the operation to evaluate the surgical effect. [Results] The average follow- up duration was 13. 7 months with a range of10 to 18 months. The low limb pain VAS score at 3 days,1,3 months postoperatively and at final follow- up decreased compared to that of preoperation,with significant difference（ P〈 0. 05）,whereas no significant difference was found between the two groups（ P 〉0. 05）. At the final follow- up,Mac Nab score were graded as excellent in 10 patients,good in 2,fair in 1respectively in PTED group,with the good to excellent results rate of 92. 3%. The Mac Nab score in conventional discectonomy group were graded as excellent in 8 patients,good in 1,fair in 1 respectively,with good to excellent results rate of 90. 0%. No significant difference was found between the two groups（ P〉 0. 05）. [Conclusion] Two surgical methods showed nearly the same clinical results. But PTED technique obviously reduced trauma,the blood loss,in- bed time and the postoperative hospital stay time. Therefore,PTED system is an ideal surgical operative method to treat adolescents lumbar disc herniation.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第21期1938-1942,共5页
Orthopedic Journal of China
关键词
青少年
腰椎间盘突出症
椎间孔镜
开窗
adolescents
lumbar disc herniation
transforaminal endoscopic
conventional discectomy
