摘要
目的探讨经皮椎间孔镜技术治疗极外侧型腰椎间盘突出症的手术技巧及临床疗效。方法2013—08—2015-01，共有21例极外侧型腰椎间盘突出症患者在我院行经皮穿刺椎间孔镜下髓核摘除、神经根减压术。采用视觉模拟评分法（VAS）对腰腿疼痛缓解情况进行评价，采用ODI功能评分及改良MacNab标准进行临床疗效评价。结果21例患者均顺利完成，手术时间55-125min，平均85min，住院时间3-6d，平均4d，手术切口均一期愈合。平均随访18个月，手术前腰腿痛VAS评分术前为（8．6±2．5）分，术后当天为（2．0±1．1）分，末次随访（1．8±0．8）分，手术前后差异有统计学意义LP〈O．05）。术前ODI为（65．4±21．8），末次随访为（12．6±4．3），差异有统计学意义（P〈0．05）。术后3例患者出现感觉异常；1例出现髓核残留，另有1例术后9个月复发，均行经椎间孔入路椎间融合术翻修后症状缓解。按照Macnab标准评定，其优良率为90．5％。结论经皮椎间孔镜技术是一种治疗极外侧型腰椎间盘突出症安全有效的微创手术方式。
Objective To explore surgical techniques and clinical results of percumneous transforaminal endoscopic diseeetomy in the treatment of far lateral lumbar disc herniation. Methods Between August 2013 and January 2015, 21 patients with far lateral lumbar disc hemiation were treated by percutaneous transforaminal endoscopic discectomy, clinical evaluation was performed with the Visual Analog Pain Seale（VAS） and OswestryLow Back Disability Index （ODI） and the modified MacNab standard. Results For all the patients, the surgery was completed successfully, with the mean operation time being 85 minutes （range,55-125 minutes）. The mean stay-in-bed time was 4 days（range, 3-6 days）. With an average follow-up of 23 months, Preoperative VAS was 8.6±2.5 and 2.0±1.1 at 1 days, and 1.8±0.8 at the last follow-up （P〈0.01）. The mean ODI was 65.4±21.8 pre- operatively and 12.6±4.3 postoperatively（P〈0.01）. Three patients（14.3%） developed burning dysesthe- sia in the sensory distribution of the operated nerve root. remnant disc fragment was found in one patient （4.8%）, and one patients （4.8%） had recurrent disc herniations, they were corrected with TLIF. According to the Macnab criteria, overall excellent or good outcomes were obtained in 19 pa- tients （90.5%） at the last follow-up. Conclusions Pereutaneous endoscopic discectomy is an safe and effective treatment method for patients with far lateral lumbar disc herniation with prominentminimal invasive advantage.
出处
《颈腰痛杂志》
2016年第3期214-218,共5页
The Journal of Cervicodynia and Lumbodynia
关键词
腰椎
微创
经皮
内镜
极外侧
腰椎间盘突出症
lumbar vertebrae
minimally invasive
percutaneous
Endoscopy
Far lateral
lumbar disc her-niation
