摘要
目的探讨经皮内窥镜下腰椎间盘摘除术(percutaneous endoscopic lumbar discectomy,PELD)术中腰椎关节突关节角对椎间孔成形与否及手术疗效的影响。方法选取2017年1月~2020年12月于笔者医院接受PELD手术的60例L 4-5腰椎间盘突出症(lumbar disc herniation,LDH)患者,在CT片上测量术前关节突关节角度,按度数平均分为三组,比较三组患者术中行椎间孔成形的例数及疗效。结果A组关节突关节角36~44.1(40.0±6.9)°,椎间孔成形3例(20%);B组关节突关节角44.2~52.3(47.2±5.6)°,椎间孔成形13例(44.8%);C组关节突关节角52.4~60.5(55.6±6.7)°,椎间孔成形11例(68.8%)。与术前相比,三组患者术后各时间点的VAS评分和ODI指数均显著改善(P<0.05),但各组之间差异无统计学意义(P>0.05)。根据术中是否行椎间孔成形将患者分为两组,椎间孔成形组27例,平均手术时间为(52.32±12.05)min,平均术中出血量为(27.27±5.32)mL,术后出现1例硬膜损伤;椎间孔未成形组33例,平均手术时间为(50.90±10.16)min,平均术中出血量为(28.03±7.37)mL,术后出现1例神经根外膜损伤,两组上述指标均无统计学差异(P>0.05)。结论PELD手术中腰椎关节突关节角度越大,需要椎间孔成形的概率越高,术中是否椎间孔成形对术后疗效无影响。
Objective To investigate the effect of lumbar facet joint angle on foraminoplasty and postoperative efficacy in percutaneous endoscopic lumbar discectomy(PELD).Methods To investigate the effect of lumbar facet joint angle on foraminoplasty and postoperative efficacy in percutaneous endoscopic lumbar discectomy(PELD).Methods Sixty patients with L 4-5 lumbar disc herniation(LDH)who underwent PELD surgery in our department from January 2017 to December 2020 were recruited in the study.The joint angle of the facet joint before surgery on CT films was measured and divided into three groups on average according to the degree.The number of cases requiring intervertebral foramina formation and the efficacy of the three groups were compared.Results The angle of facet joint in group A was 36-44.1(40.0±6.9)°,and the foraminoplasty was performed in 3 cases(20%of the group);the angle of facet joint in group B was 44.2-52.3(47.2±5.6)°,with 13 cases of foraminoplasty(44.8%);the facet joint angle of group C was 52.4-60.5(55.6±6.7)°,with 11 cases of foraminoplasty(68.8%).Compared with before operation,the VAS score and ODI index of the three groups of patients were significantly improved at each time point after operation,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the groups(P>0.05)The patients were divided into two groups according to whether the foraminoplasty was performed or not.The average operation time of the 27 cases in the foraminoplasty group was(52.32±12.05)min and the average intraoperative blood loss was(27.27±5.32)mL,and there was one case of postoperative complication.The average operation time of the 33 cases in the unformed intervertebral foramen group was(50.90±10.16)min,and the average intraoperative blood loss was(28.03±7.37)mL,and there was one case of postoperative complication.The difference was not statistically significant(P>0.05).Conclusion In PELD surgery,the greater the lumbar facet joint angle,the higher the probability
作者
施建东
缪伟
茅旭平
王素春
张文
SHI Jian-dong;MIAO Wei;MAO Xu-ping;WANG Su-chun;ZHANG Wen(Department of Orthopedics and Traumatology,Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Zhangjiagang,Jiangsu 215600,China;Institute of Orthopedics,Suzhou University,Suzhou,Jiangsu 215006,China)
出处
《颈腰痛杂志》
2023年第6期990-993,共4页
The Journal of Cervicodynia and Lumbodynia
基金
苏州市科技发展计划项目(编号:SLT2022013)。
关键词
关节突关节
腰椎间盘突出症
经皮椎间孔镜椎间盘切除术
微创技术
zygapophyseal joint
lumbar disc herniation
percutaneous endoscopic lumbar discectomy
minimally invasive technique
