摘要
目的探讨经皮全脊柱内镜下椎板间入路椎间盘切除术(percutaneous endoscopic interlaminar discectomy,PEID)微创治疗L5-S1椎间盘突出症(prolapse of lumbar intervertebral,PLID)的临床价值。方法回顾性分析2013年5月至2016年5月在我院进行手术治疗的76例PLID患者临床资料,按照数字表法随机分为观察组和对照组,每组38例。观察组行PEID治疗,对照组行传统开放手术治疗,分别对2组患者治疗前后下肢VAS评分、ODI评分、腰椎JOA评分及手术效果进行比较。结果观察组患者手术时间明显短于对照组,术中出血量明显少于对照组,差异有统计学意义(P<0.05),术后住院时间短于对照组。与术前比较,2组患者术后3、6、24个月腰痛VAS、ODI评分均降低,而JOA评分均增高,差异有统计学意义(P<0.01),但2组间对应的时间点评分比较差异则均无统计学意义(P>0.05)。结论 PEID与开放手术治疗L5-S1PLID具有较好的临床效果,但经皮脊柱内镜技术对机体创伤小,有利于术后恢复,具有很好的临床应用价值。
Objective To evaluate the clinical value of percutaneous endoscopic interlaminar discectomy in the treatment of L5-S1 prolapse of lumbar intervertebral discectomy（PLID）. Methods Retrospective analysis was made in the medical data of 76 patients with PLID who underwent surgical treatment in our hospital from May 2013 to May 2016. The patients were randomly divided into the observation group and the control group,each consisting of 38 patients. The observation group received PEID,while the control group was given traditional open surgery. Then,scores of visual analogue scale（VAS）,ODI and lumbar disc JOA were evaluated and surgical efficacy were compared between the 2 groups. Results Surgical time of the observation group was obviously shorter than that of the control group,blood loss of the observation group was significantly less than that of the control group,and the duration of stay in the hospital was also shorter than that of the control group（P〈0. 05）. As compared with those before surgery,the scores of VAS and ODI at the time points of 3,6 and 24 months after surgery were all decreased for the patients of the 2 groups,while the JOA scores were all increased（P〈0. 01）. However,no statistical significance could be seen,when comparisons were made between the 2 groups（P〈0. 05）. Conclusion PEID could produce almost the same identical clinical effects as those of open surgery in the treatment of L5-S1 PLID,nevertheless,percutaneous endoscopic interlaminar discectomy had the advantages of less trauma and faster recovery after surgery. For this reason,it promised good clinical application.
出处
《海军医学杂志》
2017年第5期411-413,425,共4页
Journal of Navy Medicine
关键词
腰椎间盘突出症
经皮脊柱内镜技术
开放椎间盘融合术
rolapse of intervertebral disc
Percutaneous endoscopic disscectomy
0 pen intervertebral fusion
