摘要
目的比较脊柱内镜与开放手术治疗腰椎间盘突出的临床疗效。方法将70例腰椎间盘突出患者按治疗方法不同分为对照组(采用椎板开窗开放手术治疗,35例)和观察组(采用脊柱内镜下手术治疗,35例)。采用JOA评分评价腰椎功能,采用疼痛VAS评分评价腰腿疼痛情况,采用ODI评估日常功能活动情况。结果患者均获得随访,时间12~36个月。术中观察组1例和术后对照组2例均出现较严重并发症,但经对症处理后均缓解。JOA评分两组术后各时间点均高于术前(P<0.05),两组比较差异均无统计学意义(P>0.05);VAS评分两组术后各时间点均低于术前(P<0.05),仅术后7 d观察组明显低于对照组(P<0.05);ODI两组术后各时间点均低于术前(P<0.05),两组比较差异均无统计学意义(P>0.05)。末次随访时两组腰椎间盘突出均未复发。结论脊柱内镜和开放手术均可有效治疗腰椎间盘突出,且脊柱内镜下手术患者创伤小,术后疼痛较轻,更利于患者恢复,但需注意严格掌握手术适应证及术中规范操作。
Objective To compare the clinical efficacy of spinal endoscopy and open surgery in the treatment of lumbar disc herniation(LDH).Methods Seventy patients with lumbar intervertebral disc herniation were divided into control group(35 cases were treated by lumbar lamina fenestration)and observation group(35 cases were treated by spinal endoscopic surgery),according to different treatment methods.JOA and VAS score were used to evaluate the lumbar function and pain situation in the waist and legs.The ODI was used to assess the activies of daily living.Results All patients were followed up for 12~36 months.During the operation,severe complications occurred in 1 case in the observation group and 2 cases in the control group,but all of them were relieved after symptomatic treatment.JOA scores of the two groups were higher than those before surgery at all time points after surgery(P<0.05),and there was no significant difference between the two groups(P>0.05);VAS in both groups were lower than those before surgery at all time points after surgery(P<0.05),only the observation group was significantly lower than the control group at 7 d after surgery(P<0.05).The ODI of the two groups was lower than that before surgery at all time points after surgery(P<0.05),and there was no statistical significance between the two groups(P>0.05).At the last follow-up,no LDH recurrence occurred in both groups.Conclusions Spinal endoscopic surgery and lumbar lamina fenestration surgery can effectively treat LDH,and spinal endoscopic surgery have less postoperative pain,and which are more conducive to recovery of the patients,but attention should be paid to strictly grasp the surgical indications and intraoperative standard operation.
作者
李锐
施永彦
刘世杰
LI Rui;SHI Yong-yan;LIU Shi-jie(Dept of Spine Surgery,Suizhou Hospitai Affiliated of Hubei University of Medicine,Suizhou,Hubei 441300,China)
出处
《临床骨科杂志》
2021年第5期641-644,共4页
Journal of Clinical Orthopaedics
关键词
脊柱内镜
腰椎间盘突出
椎板开窗
spinal endoscopy
lumbar disc herniation
lamina fenestration
