摘要
目的探讨经皮椎板间入路内镜治疗钙化型腰椎间盘突出症的临床疗效。方法 2013-05/2015-05月采用经皮椎板间入路治疗钙化型L_5~S_1椎间盘突出症患者23例。采用视觉疼痛模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)和改良的MacNab疗效评定标准对患者进行评估,并统计手术时间、术中出血量、术后并发症等指标。结果所有患者均顺利完成手术。随访12~30个月,平均25.5个月;手术时间60~120 min,平均80.3 min;术中出血10~40 ml,平均20 ml。术后各时间点VAS评分、ODI评分均较术前比较差异具有统计学意义(P<0.05)。术后末次随访时根据改良MacNab标准评价疗效,优良率为91.30%。1例术后出现脑脊液漏,2例出现下肢麻木,经保守治疗均痊愈。结论经皮椎板间入路内镜治疗钙化型腰椎间盘突出症具有创伤小、出血少、恢复快等优点,临床疗效满意。
Objective To investigate the clinical outcomes of percutaneous endoscopic interlaminar approach in treatment of calcified Ls-S1 lumbar disc herniation. Methods From May 2013 to May 2015, 23 patients with calcified lumbar disc herniation were treated with percutaneous endoscopic interlaminar approach. The visual analogue scale （VAS）, Oswestry disability index （ODD and modified MacNab efficacy evaluation criteria were used to evaluate the pa- tients, and the operation time, intraoperative blood loss, postoperative complications and other indexs were calculated. Results All the operation were successfully completed. All the patients were followed up for 12-30 （average 25.5） months. The operation time were 60-120 （average 80.3） min. Intraoperative blood loss were 10 40 （average 20） ml. There were significantly differences in the VAS and ODI scores at various time points between post operation and pre-op eration （P〈0. 05）. At the iast follow-up, the excellent and good rate was 91.30/oo according to the modified MacNab cri- teria. One patient experienced cerebrospinal fluid leakage after operation and two patients had lower limb numbness, which were cured by conservative treatment. Conclusion The percutaneous endoscopic interlaminar approach in the treat- ment of calcified lumbar disc herniationare has the advantages of little wounds, less bleeding, faster recovery, and satis-factory clinical outcomes.
作者
吴亚鹏
尚晖
王达义
常巍
赵晓琳
郭振鹏
WU Yapeng;SHANG Hui;WANG Dayi;CHANG Wei;ZHAO Xiaolin;GUO Zhenpeng(Department of Spinal Sur- gery, Taihe Affiliated Hospital of Hubei University of Medicine, Shiyan Hubei 442000, Chin)
出处
《华南国防医学杂志》
CAS
2018年第5期324-327,共4页
Military Medical Journal of South China
关键词
钙化
腰椎间盘突出症
内镜
外科手术
微创性
椎间盘切除术
经皮
椎板间入路
Calcification
Lumbar disc hernation
Endoscopy
Surgery
Minimally invasive
Discectomy
Percuta-neous
Interlaminar approach
