经皮椎间孔镜椎间盘切除术治疗腰椎间盘突出症

目的探讨经皮椎间孔镜椎间盘切除术(PTED)治疗腰椎间盘突出症的临床疗效。方法采用PTED治疗36例腰椎间盘突出症患者,采用视觉模拟评分(VAS)评价腰、腿部疼痛程度,采用Oswestry功能障碍指数(ODI)评价腰椎功能,采用改良Mac Nab标准评定临床疗效。结果手术时间60~140 min,术中出血量25~130 ml。36例均获得随访,时间9~24个月。无硬膜囊破裂、神经根损伤等并发症发生。1例术后当天出现一过性神经麻痹症状,对症处理后症状缓解;3例1周内复发,2例行PTED返修,1例行后路减压内固定术。术后各时段VAS评分及ODI均较术前减低,差异均有统计学意义(P0.05)。35例术后9个月根据改良Mac Nab标准评定疗效,优良率为91.4%。结论 PTED治疗腰椎间盘突出症具有创伤小、手术时间短、术后恢复快等优势,疗效显著。

Percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc hernia-tion

Objective To investigate the clinical efficacy of percutaneous transforaminal endoscopic discectomy ( PT-ED) in the treatment of lumbar disc herniation. Methods Thirty-six patients with lumbar disc herniation were trea-ted with PTED. Visual analogue scale ( VAS) was used to evaluate the degree of pain in the lumbar and leg, Oswe-stry disability index ( ODI) was used to evaluate the function of lumbar, and the clinical efficacy was evaluated by the modified MacNab standard. Results The operation time was 60~140 min, the volume of bleeding during operation was 25~130 ml. All cases were followed up from 9 months to 24 months. No dural sac rupture, nerve root injury and other complications occurred. One day after the operation, 1 case had recurrent nerve palsy, after symptomatic treat-ment, the symptoms gradually disappeared, 3 cases of postoperative recurrence, 2 cases performed PTED revision, 1 case performed posterior decompression and internal fixation. Postoperative VAS and ODI were significantly reduced, the difference was statistically significant (P<0. 05). After 9 months, 35 cases of the efficacy of the improved Mac-Nab standard was 91. 4%. Conclusions PTED in treatment of lumbar disc herniation has advantages of less trauma, shorter operation time and rapid recovery, which is safe and effective in the treatment of lumbar disc herniation.