自制辅助定位穿刺装置在经皮椎间孔镜下髓核摘除术中的应用效果

目的 探讨自制辅助定位穿刺装置在经皮椎间孔镜下髓核摘除术(PELD)中的应用效果.方法 选择单一节段椎间盘突出患者120例,其中病变位于L4/5节段者60例,L5/S1者60例.将L4/5节段患者随机分为A组与B组,各30例,将L5/S1节段患者随机分为C组与D组,各30例.4组均行PELD,其中A组与C组采用自制装置进行靶向穿刺置管,B组与D组采用常规经椎间孔入路技术进行穿刺置管.比较A、B两组和C、D两组的一次穿刺成功率、定位穿刺时间、置管时间以及手术透视次数.结果 所有患者均顺利完成手术,术中及术后均未出现严重的并发症.A组与C组的一次穿刺成功率、定位穿刺时间、置管时间及术中X线透视次数分别优于B组与D组(P<0.05).结论 在PELD术中采用自制辅助装置能有效辅助行穿刺置管,有更高的穿刺效率,并降低术者和患者接受透视辐射次数.

Application effect of self-made assisted device for positioning puncture during percutaneous endoscopic lumbar discectomy

Objective To investigate the application effect of self-made assisted device for positioning puncture during percutaneous endoscopic lumbar discectomy ( PELD) .Methods A total of 120 patients with single segment disc herniation were selected .The lesions were located in L4/5(n=60) or L5/S1(n=60).The patients with lesions located in L4/5 were randomly divided into group A and group B,with 30 cases in each group .The patients with lesions located in L 5/S1 were randomly divided into group C and group D , with 30 cases in each group.PELD was conducted in the four groups .Targeted puncture and catheterization using self-made assisted device were performed in group A and group C.Puncture and catheterization by conventional transforaminal approach were performed in group B and group D .The one-time successful rate of puncture,duration for location and puncture,duration for catheterization and the times of intraoperative X-ray were compared between group A and group B or between group C and group D.Results The operation was successfully completed in all patients.No severe complications occurred during or after operation .The one-time successful rate of puncture ,duration for location and puncture ,duration for catheterization,and the times of intraoperative X-ray of group A and group C were better than those of group B and group D respectively (P<0.05).Conclusion Application of self-made assisted device during PELD can provide an effective assistance for puncture and catheterization,with higher puncture effectiveness ,and can reduce the times of X-ray surgeons and patients received .