摘要
目的探讨低浓度腰麻下经皮椎间孔镜术治疗腰椎间盘突出症的疗效和安全性。方法选取2017年6月至2019年6月在我科行低浓度腰麻下经皮椎间孔镜术治疗的腰椎间盘突出症患者120例(共120个椎间隙),患者术前均存在腰腿痛症状,影像检查证实为单节段腰椎间盘突出,应用0.18%罗哌卡因5 mL腰麻下行椎间孔成形及髓核摘除术。比较术前、术后不同时间的腰痛及腿痛视觉模拟评分法(VAS)评分,分析术后6个月的治疗优良率。结果所有患者的手术均顺利完成,手术时间50~120 min,平均(78.1±10.0)min,术中出血量约30 mL。术后随访6个月,术后1 d、3个月、6个月腰痛和腿痛VAS评分均较术前降低,差异具有统计学意义(P<0.01)。术后6个月随访时,患者的治疗优良率为97.5%。结论低浓度腰麻下经皮椎间孔镜术在摘除突出髓核的同时,能够充分对椎间孔进行扩大、减压,应用于腰椎间盘突出症患者是安全、有效的,且患者具有良好的耐受性和舒适度。
Objective To explore the efficacy and safety of percutaneous transforaminal endoscopic lumbar discectomy under spinal anesthesia of low concentration in the treatment of lumbar disc herniation.Methods From June 2017 to June 2019,120 patients(120 intervertebral spaces)with lumbar disc herniation treated by percutaneous transforaminal endoscopic surgery under spinal anesthesia of low concentration in our department were selected.All patients had low back pain and leg pain before operation,and the imaging examination confirmed that the patients were single segment lumbar disc herniation,then spinal anesthesia with 0.18%ropivacaine 5 mL was used for intervertebral foramen plasty and nucleus pulposus removal.The visual analogue scale(VAS)scores of low back pain and leg pain before operation and at different time after operation were compared,and the excellent and good rate of treatment at 6 months after operation was analyzed.Results The operations of all patients were successfully completed,the operation time was 50-120 min,with an average of(78.1±10.0)min,and the intraoperative blood loss valume was about 30 mL.The patients were followed up for 6 months after operation,VAS scores of low back pain and leg pain at 1 day,3 months and 6 months after operation were lower than those before operation,and the differences were statistically significant(P<0.01).At 6 months of follow-up after operation,the excellent and good rate of traetment was 97.5%.Conclusion Percutaneous transforaminal endoscopic surgery under spinalanesthesia of low concentration can fully expand and decompress the intervertebral foramen within removing the herniated nucleus pulposus and is safe and effective applied in patients with lumbar disc herniation,with good tolerance and comfort for patients.
作者
孙义军
龚福太
郑宇
孙晴
王向阳
祝志强
李俊
SUN Yijun;GONG Futai;ZHENG Yu;SUN Qing;WANG Xiangyang;ZHU Zhiqiang;LI Jun(Orthopedics and Traumatology Department,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021;No.1 Orthopedics Department,Shaanxi Traditional Chinese Medicine Hospital,Xi'an 710004,China)
出处
《临床医学研究与实践》
2020年第30期28-30,共3页
Clinical Research and Practice
基金
陕西省卫生健康科研基金项目(No.2018E008)。
关键词
腰麻
经皮椎间孔内镜技术
腰椎间盘突出症
椎间盘髓核摘除术
spinal anesthesia
percutaneous transforaminal endoscopic surgery
lumbar disc herniation
percutaneous lumbar discectomy
