靶向成形椎间孔镜技术治疗游离脱垂型腰椎间盘突出症

目的:评价靶向成形椎间孔镜技术治疗游离脱垂型腰椎间盘突出临床疗效。方法:2015年6月至2016年1月,采用靶向成形椎间孔镜技术治疗游离脱垂型腰椎间盘突出症25例,其中男14例,女11例;年龄23~52岁,平均37.6岁;L_(2,3)1例,L_(3,4)3例,L_(4,5)12例,L_5S_19例。术前、术后1周、1年进行采用视觉摸拟(visual analogue scale,VAS)评分对患者的腰痛、腿痛进行评分,采用Oswestry功能障碍指数(Oswestry Disability Index,ODI)对腰椎功能进行评定。结果:所有患者获得随访,时间12~19个月,平均15.2个月。25例患者平均手术时间为108.6 min。术后无硬脊膜和神经根损伤、切口感染、复发病例。术前、术后1周、1年腰痛VAS评分分别为5.8±0.5、2.5±0.4、0.9±0.2;腿痛VAS评分分别为7.1±0.6、1.5±0.4、0.7±0.6;腰椎ODI评分分别为69.2±1.8、22.5±4.7、10.2±2.4,各项目三者之间两两差异有统计学意义(P0.05)。结论:靶向成形椎间孔镜技术治疗游离脱垂型腰椎间盘突出症不仅具有创伤小、出血量及并发症少、恢复快等优点,而且疗效确切、安全、有效。

Treatment of migrated lumbar disc herniation with percutaneous endoscopic lumbar discectomy and target foraminoplasty

Objective: To evaluate the clinical outcome of percutaneous endoscopic lumbar discectomy with target foraminoplasty in treating migrated lumbar disc herniation.Methods: From June 2015 to January 2016,25 patients with migrated lumbar disc herniation were treated with percutaneous endoscopic lumbar discectomy with target foraminoplasty. A total of 14 males and 11 females,aging from 23 to 52 years old (average:37.6) were enrolled in this study. Discectomy occurred in L_2,3 of 1 case,L_3,4 of 3 cases,L_4,5 of 12 cases,L₅S₁ of 9 cases. Preoperative,1-week and 1-year postoperative visual analogue scale (VAS) scores were collected to evaluate lower back and leg pain;Oswestry Disability Index(ODI) was used to assess the lumbar function.Results: All the patients were followed up for 12 to 19 months with an average of 15.2 months. The mean operation time was 108.6 min. No injury of dura,nerve root,or wound infection were found. Preoperative,1-week and 1-year postoperative visual analogue scale(VAS) scores of lower back pain were 5.8±0.5,2.5±0.4,0.9±0.2,respectively,with significant differences among each other(P<0.05);VAS scores of leg pain were 7.1±0.6,1.5±0.4,0.7±0.6,respectively,with significant differences among each other(P<0.05). Lumbar ODI scores were 69.2±1.8,22.5±4.7,10.2±2.4 at the above time points and showed significant differences among each other(P<0.05).Conclusion: Percutaneous endoscopic lumbar discectomy with target foraminoplasty for migrated lumbar disc herniation showed advantages of less injuries,bleeding and complication. It also promotes rapid recovery,being curative safely and effectively.