经皮椎间孔镜术治疗腰椎间盘突出症合并后 纵韧带骨化的疗效分析

目的 探讨经皮椎间孔镜术治疗腰椎间盘突出伴后纵韧带骨化的方法及疗效。方法 回顾性分析2016年1月至2018年1月收治的14例腰椎间盘 突出伴后纵韧带骨化的临床资料，均采用经皮侧路镜技术进行治疗。术后平均随访时间8.4 个月。术前及术后1 d和1、3、6 个月采用视觉模拟量表 （VAS）评分评估腰腿痛、Oswestry功能障碍指数（ODI）评估腰椎功能，改良MacNab疗效评分评定临床疗效。结果 14例均顺利完成手术。术后1 d和 1、3、6 个月腰腿痛VAS评分、ODI较术前均明显改善（P<0.05）。术后6个月，改良MacNab临床疗效评价:优11例，良2例，可1例；优良率为 93%（13/14）。结论 经皮椎间孔镜技术可有效治疗腰椎椎间盘突出伴后纵韧带骨化，使神经根得到及时彻底减压及松解，临床效果显著，但须严格 把握手术适应证。

Treatment of lumbar disc herniation with ossification of posterior longitudinal ligament by percutaneous intervertebral foramen endosdcope surgery

Objective To explore the operative technique of percutaneous intervertebral foramen endoscope surgery for the lumbar disc herniation (LDH) with ossification of posterior longitudinal ligament (OPLL). Methods The percutaneous intervertebral foramen endoscope surgery was performed from January, 2016 to January, 2018. in 14 patients with LDH complicated with OPLL. The clinical effects were assessed by visual analogue scale (VAS), and Oswestry disability index (ODI). The prognosis was assessed by modified MacNab standard on the last following up. All the patients were followed up for mean 8.4 months. Results VAS scores of low back pain and ODI were significantly lower 1, 30, 90 and 182 days after the operation than those before the operation in all the patients (P<0.05). The rate of good prognosis was 93.3% according to the modified MacNab standard on the last following up. Conclusion The percutaneous intervertebral foramen endoscope surgery is an effective method to treat LDH with OPLL, because the nerve root can be decompressed and relaxed completely in time by this operation, but the indication of operation must be strictly grasped.