摘要
[目的]研究经皮全脊柱内镜技术（percutaneous endoscopic lumbar discectomy,PELD）治疗腰椎间盘突出症的临床疗效及安全性。[方法]回顾性研究2013年1月~2015年1月连续接受手术治疗的153例单节段伴有单侧神经根性症状的腰椎间盘突出症患者,其中68例行经皮全脊柱内镜下腰椎间盘髓核摘除术（内镜组）,85例行开放腰椎间盘髓核摘除术（开放组）。采用视觉模拟评分法（VAS评分）、Oswestry功能障碍指数（ODI）、Mac Nab评分评定疗效。[结果]所有患者均完成手术,内镜组有1例出现神经根损伤。其他患者未发生神经、血管损伤等严重并发症。内镜组手术时间大于开放组,术中出血量、切口长度小于开放组,差异均有统计学意义（P〈0.05）。术后3 d和末次随访时腰痛VAS评分内镜组显著小于开放组,差异有统计学意义（P〈0.05）,术后3 d腿痛VAS评分内镜组小于开放组,差异有统计学意义（P〈0.05）,末次随访时两组腿痛VAS评分差异无统计学意义（P〉0.05）。内镜组末次随访时ODI指数小于开放组,差异有统计学意义（P〈0.05）,两组疗效优良率差异无统计学意义（P〉0.05）。两组术后腰痛、腿痛VAS评分显著小于术前,差异有统计学意义（P〈0.05）,内镜组术后3 d和末次随访时腰痛、腿痛VAS评分差异无统计学意义（P〉0.05）。开放组术后3 d和末次随访时腰痛VAS评分差异无统计学意义（P〉0.05）,末次随访时腿痛VAS评分小于术后3 d,差异有统计学意义（P〈0.05）。[结论]经皮全脊柱内镜下腰椎间盘髓核摘除术治疗腰椎间盘突出症安全有效,创伤小,恢复快,是开放腰椎间盘髓核摘除术很好的替代技术。
[Objective] To investigate the clinical effect and safety of percutaneous endoscopic lumbar discectomy（ PELD） for lumbar disc herniation. [Methods] From January 2013 to January 2015,153 patients with single level unilateral radicular pain were retrospectively reviewed. In them,68 patients received PELD surgery（ group A）,and other 85 patients were treated with small incision technique（ group B）. The surgery time,intraoperative visual analog scale（ VAS） scores and complications were recorded,and the outcomes were compared between two groups with VAS score,Oswestry disability index（ ODI） and modified Macnab criteria. [Results] Except for 1 case in group A suffering nerve injury,all patients received surgeries successfully. No neurological or vascular complications occurred in other patients. The mean surgery time of group A was longer than that of B,the bleeding volume and incision length of group A was significantly better than that of group B（ P〈0. 05）. The VAS scores of pain in the low back at 3 days postoperatively and at final follow- up in group A were significantly less than those in group B（ P〈0. 05）. The VAS scores of pain in the leg in group A was less than that in group B at 3 days postoperatively,with significantly statistical difference（ P〈0. 05）,but with no significantly statistical difference（ P〉0. 05）at final follow- up. The VAS scores of pain in the low back and leg at 3 days postoperatively and at final follow- up were significantly less than preoperative ones in group A and B,respectively,showing significantly statistical difference（ P〈0. 05）. At final follow- up,the ODI indexes were less than preoperative ones in both group A and B,meanwhile,it was less in group A than in group B,with significantly statistical difference（ P〈0. 05）. The satisfactory rate from patients in group A and B was found no significantly statistical difference（ P〉0. 05）. [Conclusion] PELD is effective and safe in treating lumbar disc herniation, with advantages o
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2016年第9期774-779,共6页
Orthopedic Journal of China
