摘要
目的 评价经皮椎间孔镜技术治疗腰椎固定术后邻近节段椎间盘突出症的临床疗效。方法 2014年3月~2019年7月,采用经皮椎间孔镜技术治疗腰椎固定术后邻近节段椎间盘突出症患者26例,其中男18例,女8例;年龄21~72岁,本次手术距离腰椎固定术后3~15年。手术节段:L_(3-4)3例,L_(4-5)12例,L_(5-S1)11例;均采用经皮椎间孔镜技术治疗。术后即刻、1 d、1个月、3个月和2年进行VAS评分,术后2个月以Oswestry功能障碍指数评估腰椎功能,采用改良MacNab标准判定疗效。结果 26例患者获随访,随访时间24~36个月。患者术后较术前症状明显改善,腰痛及下肢疼痛减轻,术后即刻、1 d、1个月、3个月以及术后2年的VAS评分较术前显著降低(P<0.01),术后2年时ODI指数显著低于术前(P<0.05)。末次随访时,采用改良MacNab评分标准评定手术疗效:优21例,良4例,可1例,优良率96%。结论 经皮椎间孔镜技术治疗腰椎固定术后邻近节段椎间盘突出症,对脊柱稳定性结构破坏小,减压彻底,术后患者恢复快,疗效满意。
Objective To evaluate the clinical efficacy of percutaneous foraminal endoscopy in the treatment of adjacent segment disc herniation after lumbar spine fixation surgery.Method From March 2014 to July 2019,26 patients with adjacent segment intervertebral disc herniation after lumbar spine fixation surgery were treated with percutaneous foraminal endoscopy,including 18 males and 8 females;The age range was 21-72 years,and this surgery was 3-15 years after lumbar spine fixation surgery.Surgical segments:L_(3-4)3 cases,L_(4-5)12 cases,L_(5-S1)11 cases;All patients were treated with percutaneous foraminal endoscopy.VAS scores were performed immediately,1 day,1 month,3 months,and 2 years after surgery.Lumbar function was evaluated using the Oswestry Dysfunction Index 2 months after surgery,and the efficacy was evaluated using the modified MacNab standard.Result 26 patients were followed up for 24-36 months.The patients’postoperative symptoms were significantly improved compared to preoperative,with reduced back pain and lower limb pain.The VAS scores immediately,1 day,1 month,3 months,and 2 years after surgery were significantly lower than preoperative(P<0.01),and the ODI index at 2 years after surgery was significantly lower than preoperative(P<0.05).At the last follow-up,the modified MacNab scoring system was used to evaluate the surgical efficacy:excellent in 21 cases,good in 4 cases,and fair in 1 case,with an excellent and good rate of 96%.Conclusion Percutaneous foraminal endoscopy technique for the treatment of adjacent segment intervertebral disc herniation after lumbar spine fixation surgery has minimal structural damage to spinal stability,thorough decompression,rapid postoperative recovery,and satisfactory therapeutic effect.
作者
高利峰
刘雅普
李鹏
郑笑臣
王松茂
徐永辉
候秀伟
吴广良
GAO Li-feng;LIU Ya-pu;LI Peng;ZHENG Xiao-chen;WANG Song-mao;XU Yong-hui;HOU Xiu-wei;WU Guang-liang(Spinal Surgery Department of the Second Affiliated Hospital of Henan Luohe Medical College,Luohe,Henan 462300,Henan)
出处
《颈腰痛杂志》
2024年第3期442-445,共4页
The Journal of Cervicodynia and Lumbodynia
基金
河南省卫健委医学科技攻关计划联合共建项目(编号:LHGJ20200887)
漯河医专创新发展能力提升工程项目(编号:2019-LYZKYYB031)。
关键词
椎间孔镜
腰椎固定术后
邻近节段退变
椎间盘突出症
intervertebral foramen mirror
after lumbar spine fixation surgery
adjacent segment degeneration
intervertebral disc herniation
