摘要
目的比较全可视化脊柱内镜辅助动力磨钻与环锯两种关节突成形工具在治疗腰椎间盘突出症(LDH)的早期临床疗效。方法回顾性分析2019年6月至2021年12月在首都医科大学附属北京友谊医院接受治疗的88例腰椎间盘突出患者的临床资料。按手术使用关节突成型工具分成两组,一组使用镜下动力磨钻行椎间孔成型,设为磨钻组(n=44);另一组使用镜下可视化环锯行椎间孔成型,设为环锯组(n=44)。记录并比较两组患者手术时间、切口长度、术中透视次数、切口愈合时间、术前及术后两组间腰视觉模拟评分法(VAS)、腿VAS和Oswestry功能障碍指数(ODI)评分。结果两组患者随访12~31个月,平均(16.43±4.92)个月。磨钻组的手术时间为(147.86±37.15)min,明显长于环锯组[(100.91±33.83)min],差异有统计学意义(P<0.05)。两组间在切口长度、术中透视次数、切口愈合时间比较,差异均无统计学意义(P>0.05)。术后3、6、12个月时,磨钻组和环锯组的腰VAS、腿VAS和ODI评分均较术前显著下降,差异均有统计学意义(P<0.05),但两组间腰VAS、腿VAS和ODI评分比较,差异均无统计学意义(P>0.05)。结论环锯和磨钻这两种关节突成形工具,在经皮椎间孔镜治疗LDH安全、有效,均可取得满意的近期疗效。全可视化脊柱内镜环锯,成形效率更高,手术时间更短。
Objective To compare the early clinical effects of fully visualized spinal endoscope-assisted power drill and trephine in the treatment of lumbar disc herniation(LDH).Methods The dinicaldata of 88 patients with lumbar disc herniation treated in Beijing Friendship Hospital,Capital Medical University from June 2019 to December 2021 were retrospectively analyzed.The patients were divided into two groups according to the use of arthroplasty tools:the drill group(n=44)was treated with endoscopic dynamic milling and the trepanation group(n=44)was treated with endoscopic visualization trephine.The time of operation,the length of incision,the times of fluoroscopy during operation,the healing time of incision,the visual analogue scale(VAS)of lumbar,leg and Oswestrydisability index(ODI)scores before and after operation were recorded and compared between the two groups.Results The patients were followed up for 12-31 months,mean(16.43±4.92)months.The operation time in the drill group was(147.86±37.15)min,which was significantly longer than that in the trepanation group[(100.91±33.83)min],the difference was statistically significant(P<0.05).There was no statistically significant difference in the length of incision,the times of fluoroscopy and the time of wound healing between the two groups(P>0.05).At 3,6,and 12 months after operation,the lumbar VAS,leg VAS,and ODI scores of the drill group and the trepanation group were significantly lower than those before surgery,the differences were statistically significant(P<0.05);but there were no statistically significant differences in lumbar VAS,leg VAS,and ODI scores between the two groups(P>0.05).Conclusion Percutaneous microendoscopic discectomy is a safe and effective method for the treatment of lumbar disc herniation with two kinds of arthroplasty tools.Fully visualized spinal endoscopic trephining is more efficient and the operation time is shorter.
作者
谢学虎
张国强
刘宁
杨雍
刘雨泉
韩宇星
XIE Xue-hu;ZHANG Guo-qiang;LIU Ning(Department of Orthopedic Spine Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2023年第23期2524-2527,共4页
Journal of Clinical and Experimental Medicine
基金
北京市卫生系统215高层次卫生技术人才培养计划项目(编号:2015-3-009)。
关键词
椎间盘
可视化脊柱内镜
腰椎间盘突出症
关节突成形术
磨钻
环锯
Intervertebral disc
Visual spinal endoscope
Lumbar disc herniation
Facet arthroplasty
Drill
Trephine
