经皮椎间孔镜治疗腰椎间盘突出症的疗效分析

目的探讨经皮椎间孔镜技术(PTED)在治疗经保守治疗无效的腰椎间盘突出症中的临床应用价值。方法选择单节段椎间盘突出症经保守治疗无效患者50例,随机分成两组:经椎间孔镜下行椎间盘髓核摘除术25例(观察组),传统开放手术25例(对照组),对比两种手术治疗腰椎间盘突出症的临床疗效。结果手术进展顺利,术后两组患者腰痛症状均缓解。观察组患者手术切口大小、出血量、术后卧床时间较对照组少(P0.05),手术时间两组无统计学差异(P0.05)。患者均随访3个月,两组患者手术治疗1个月与3个月JOA评分相比无显著差异,两组均无硬脊膜破裂、神经根损伤等并发症,仅对照组1例对照组患者术后当天出现一过性神经麻痹,对症处理后症状逐渐缓解。结论与传统开放治疗相比,经皮椎间孔镜技术治疗椎间盘突出症疗效相当,但具有创伤小、恢复快等优点,是一项有效的治疗手段。

Treatment of prolapsed lumbar disc herniation by transforaminal endoscopic spine system and surgical experience.

Objective To evaluate the clinical efficacy of percutaneous transforaminal lumbar spinal endoscopic technique on the treat- ment of lumbar disc herniation. The conservative treatment of lumbar disc herniation is invalid. Methods 50 cases with lumbar intervertebral disc herniation were included into this study. All these patients were randomly divided into the treatment group and the observation group. Patients of treatment group were treated with percutaneous transforaminal lumbar spinal endoscopic technique, while patients of observation group were treated with open lumbar diseetomy. Results The backache symptom of the patients disappeared and the straight leg - raising test of the treatment group immediately became negative after the operation. Compared to observation group, the treatment group is lower in the aspects of the incision size, bleeding volume and postoperative recovery time. Meanwhile, there was no significant difference between two groups in operation time. All patients were follow - up for three months, there was no difference in JOA score after 1 month and 3 month. There were no catheter brolen and nerve root injury. And transient nerve palsy occurred in one patient on day 1 after operation in observation group and disappeared after several days without special treatment. Conclusion Compared with open lumbar disectomy, percutaneous transforaminal lumbar spinal endoscopic technique was an effective treatment for lumbar disc herniation, with the advantages of less trauma and bleeding, rapid recovery and fewer complication.