摘要
目的对比经皮椎间孔镜技术和椎板开窗减压术治疗腰椎间盘突出症的临床疗效。方法收集我院2017年2月~12月住院手术治疗的腰椎间盘突出症患者60例,随机分为经皮椎间孔镜组和椎板开窗组,每组30例。经皮椎间孔镜组采用经皮椎间孔镜手术治疗,椎板开窗组采用椎板开窗髓核摘除手术治疗。对比两组患者手术切口长度、术中出血量和手术时间,于术前、术后7d、术后1个月、术后3个月和术后6个月采用VAS评分评价患者疼痛程度,采用ODI指数评价患者脊柱活动功能,末次随访时行Macnab疗效评级。结果与椎板开窗组比较,经皮椎间孔镜组的手术切口长度缩短,术中出血量减少,差异具有统计学意义(P<0.05)。两组患者术后VAS评分、ODI指数均较术前降低,差异具有统计学意义(P<0.05)。经皮椎间孔镜组术后7 d和术后1个月的VAS评分、ODI指数低于椎板开窗组,差异具有统计学意义(P<0.05)。两组治疗有效率比较,差异无统计学意义(P>0.05)。结论经皮椎间孔镜和椎板开窗减压术均可有效治疗腰椎间盘突出症,经皮椎间孔技术更有利于术后早期疼痛症状缓解和脊柱功能恢复。
Objective To compare the clinical efficacy of percutaneous transforaminal endoscopy and decompression of vertebral lamina fenestration in the treatment of lumbar disc herniation.Methods 60 patients with lumbar disc herniation who were hospitalized from February to December 2017 were randomly divided into percutaneous transforaminal endoscopy group and decompression of vertebral lamina fenestration group with 30 cases in each group.Percutaneous transforaminoscopic surgery was performed in the group of percutaneous transforaminal endoscopy,laminectomy and nucleus pulposus resection was performed in the group of decompression of vertebral lamina fenestration.The operation incision length,intraoperative bleeding volume and operation time were compared between the two groups.VAS score was used to evaluate the pain degree before operation,7d after operation,1 month after operation,3 months after operation and 6 months after operation.ODI index was used to evaluate the spinal motion function of the patients.At the last follow-up,the curative effect of Macnab was evaluated.Results Compared with the decompression of vertebral lamina fenestration group,the length of incision was shortened and the amount of bleeding was reduced in the percutaneous transforaminal endoscopy group,the difference was statistically significant（P〈0.05）.The postoperative VAS score and ODI index of the two groups were significantly lower than those before operation,the difference was statistically significant（P〈0.05）.The VAS score and ODI index of the transforaminal endoscopy group were significantly lower than those of the decompression of vertebral lamina fenestration group at 7d and 1 month after operation,the difference was statistically significant（P〈0.05）.There was no significant difference in the effective rate between the two groups（P〉0.05）.Conclusion Percutaneous transforaminal endoscopy and decompression of vertebral lamina fenestration can effectively treat lumbar disc herniation.Percutaneous transforaminal decomp
作者
刘国铭
林世水
周仕国
LIU Guo-ming;LIN Shi-shui;ZHOU Shi-guo(Department of Orthopaedics,Lijinshan HospitaI,Fuzhou 350001,Fujian,China)
出处
《医学信息》
2018年第17期66-70,共5页
Journal of Medical Information
关键词
腰椎间盘突出症
经皮椎间孔镜手术
椎板开窗减压术
Lumbar disc herniation
Percutaneous transforaminal endoscopic surgery
Decompression of vertebral lamina fenestration
