摘要
目的评价经皮脊柱内镜经椎板入路治疗向上重度游离型腰椎间盘突出症的临床疗效及安全性。方法回顾性分析2016年2月至2020年6月在我院行经皮脊柱内镜经椎板入路治疗向上重度游离型腰椎间盘突出症患者21例,随访时间12~24个月,平均18个月,统计患者手术时间、术中出血量、透视次数、术后住院时间。通过患者术前、术后1个月、3个月、6个月、12个月的腰痛、腿痛视觉模拟评分(visual analogue scale,VAS)及Oswestry功能障碍指数(oswestry disability index,ODI)评价手术疗效,术后12个月时采用MacNab标准评价手术优良率。结果21例术后各时间点腰痛、腿痛VAS评分及ODI较术前明显改善,差异有统计学意义(P<0.05),术后12个月时按MacNab标准评定,优16例,良3例,可2例,优良率90%。结论经皮脊柱内镜经椎板入路治疗向上重度游离型腰椎间盘突出症具有手术时间短、手术创伤小、术后恢复快,疗效确切的优势,手术安全可行。
Objective To evaluate the effect and security of percutaneous spinal endoscopic for severe high-grade up-migrated lumbar disc herniation via a translaminar keyhole approach.Methods A series of 21patients with severe high-grade up-migrated lumbar disc herniation were reviewed in this study,all were treated with translaminar percutaneous endoscopic lumbar discectomy(PELD)between February 2016 and June 2020.All were followed-up for 12-24 months(mean:18 months).The operation time,blood loss,radiation frequency and postoperative hospital stay were recorded.Clinical outcomes were assessed by visual analog scale(VAS)for back and leg pain,and Oswestry Disability Index(ODI)before surgery,1 month,3 months,6 months,and 12 months after surgery.The curative effect of the operation was evaluated by MacNab criteria at 12 months postoperatively.Results The postoperative VAS for back and leg pain,and ODI were significantly improved after surgery(P<0.05).According to the MacNab criteria,the satisfaction rate was 90%(excellent in 16 cases,good in 3 cases,fair in 2 cases).Conclusions Translaminar PELD is safe and effective for severe high-grade up-migrated lumbar disc herniation,which has the advantages of short operation time,less operation trauma,faster recovery and satisfactory effect.
作者
张智
刘元彬
郑佳状
汪凡栋
陈宇
ZHANG Zhi;LIU Yuan-bin;ZHENG Jia-zhuang;WANG Fan-dong;CHEN Yu(Department of Orthopaedics,Chengdu Fifth People's Hospital,Chengdu,Sichuan,611130,China)
出处
《中国骨与关节杂志》
CAS
2023年第1期76-79,共4页
Chinese Journal of Bone and Joint
关键词
腰椎
椎间盘移位
最小侵入性外科手术
Lumbar vertebrae
Intervertebral disc displacement
Minimally invasive surgical procedures
