摘要
目的比较经皮椎间孔镜(percutaneous transformational endoscopicdiscectomy,PTED)与可动式椎间盘镜(mobile microendoscopic discectomy,MMED)治疗脱出游离型腰椎间盘突出症的近期疗效。方法回顾性分析2015年11月~2019年3月手术治疗的脱出游离型腰椎间盘突出症60例,PTED及MMED治疗组各30例。比较两种治疗方式手术时间、术中出血量、透视次数、神经损伤等情况。手术效果参照VAS评分、ODI指数、改良Macnab标准进行疗效评定。结果PTED组手术时间及术中透视次数较MMED组更多(P<0.05),但术中出血量少于MMED组(P<0.05);两组术中神经损伤并发症差异无统计学意义(P>0.05)。PTED组术后1个月时腰痛恢复优于MMED组(P<0.05),但术后3个月恢复水平相近(P>0.05);术后7 d,PTED组较MMED组的下肢疼痛评分更低(P<0.05),但在3月时两组恢复至一致水平(P>0.05)。PTED组ODI指数术后1个月内恢复优于MMED组(P<0.05);术后3月时两组间无统计学差异(P>0.05)。两组手术术后3个月的Macnab疗效均满意(P>0.05)。结论PTED与MMED治疗脱出游离型腰椎间盘突出症的近期疗效相似,安全性高;PTED对软组织及对椎管内神经根损伤更小,术后可更快恢复日常生活及工作,但其手术时间及放射线暴露多于MMED组。
Objective To compare the short-term efficacy of percutaneous transformational endoscopic discectomy(PTED)and mobile microendoscopic discectomy(MMED)in the treatment of free type lumbar intervertebral disc protrusion.Methods A total of sixty patients with prolapsed free lumbar disc herniation who received endoscopic surgery in Huangshan Shoukang Hospital from November 2015 to March 2019 were retrospectively collected.Among them,30 patients were treated with PTED and 30 patients were treated with MMED.The operative time,intraoperative blood loss,number of fluoroscopy and nerve injury of the two groups were compared.The efficacy was evaluated by visual analogue scale(VAS),the modified Oswestry disability index(ODI)and the modified Macnab standard.Results Duration of operation and intraoperative fluoroscopy frequency in PTED group were higher than those in MMED group(P<0.05).However,the intraoperative blood loss in the PTED group was less than that in the MMED group(P<0.05).The operative nerve complications were similar between the two groups(P>0.05).The recovery of lower back pain in PTED group was better than that in MMED group at one month after surgery(P<0.05),then the pain level was similar between the two groups at three months after surgery(P>0.05).At 7 days after surgery,the lower limb pain score in the PTED group was lower than that in the MMED group(P<0.05),but the two groups recovered to the same level at 3 months after surgery(P>0.05).ODI dysfunction index of PTED group recovered faster within 1 month after surgery,which was better than that of MMED group(P<0.05).At 3 months after surgery,there was no significant difference in ODI dysfunction index between the two groups(P>0.05).Macnab score evaluation at three months after operation in both two groups was satisfactory(P>0.05).Conclusion Both MMED and PTED endoscopic spinal surgery for free type lumbar intervertebral disc protrusion can achieve satisfactory results,with similar short-term efficacy and high safety.Compared with MMED group,PTED group has le
作者
王建华
程翰林
黄顺水
姚小波
WANG Jian-hua;CHENG Han-lin;HUANG Shun-shui;YAO Xiao-bo(Department of Orthopedics,Huangshan Shoukang Hospital,Huangshan,Anhui,245000 China)
出处
《颈腰痛杂志》
2020年第1期71-74,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
可动式椎间盘镜
经皮椎间孔镜
微创
脱出游离型
腰椎间盘突出症
mobile microendoscopic discectomy
percutaneous transformational endoscopic discectomy
minimally invasive
prolapse free type
lumbar disc herniation
