经皮脊柱内镜下手术治疗腰5-骶1椎间盘突出症

目的 探讨经皮脊柱内镜下手术治疗腰5-骶1椎间盘突出症的方法及效果。方法 回顾性分析2013年3月至2016年1月经皮脊柱内镜下手术治疗的38例腰5-骶1腰椎间盘突出症的临床资料，采用经椎间孔入路26例，经椎板间入路12例。手术前后采用疼痛视觉模拟量表（VAS）评分、MacNab量表评分、KPS评分和日本骨科协会（JOA）评分评估疗效。随访时间大于6个月。结果 38例中，34例（89.5%）疗效优良。术后VAS评分[（1.0±1.5）分]较术前[（7.9±1.1）分]明显降低（P<0.05）。术后腰椎JOA评分[（21±5.7）分]较术前[（7.4±4.6）分]明显提高（P<0.05）。经椎间孔入路和经椎板间入路的手术疗效无明显差异。结论 经皮脊柱内镜下选择椎间孔入路或椎板间入路均可有效、安全并且微创地治疗腰5-骶1腰椎间盘突出症。

Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation

Objective To investigate the treating strategy of percutaneous endoscopic lumbar discectomy (PELD) for L5-S1 disc herniation. Methods The clinical data of 38 patients with L5-S1 disc herniation, of whom, 26 underwent percutaneous endoscopic transforaminal discectomy (PELD) and 12 percutaneous endoscopic interlaminar discectomy (PEID) from 2016 to 2013, were analyzed retrospectively. The clinical outcomes were assessed by the visual analogue scale (VAS) and modified Macnab functional classification in all the patients who were followed up for over 6 months. Results Of 38 patients, 34 (89.5%) received excellent or good outcomes after the surgery. The VAS scores [(7.9±1.1) points] were significantly higher before the surgery than those [(1.0±1.5)] after the surgery (P<0.05). There were no significant differences in the postoperative VAS scores between 12 patients undergoing PEID and 26 patients undergoing PETD. Conclusion PELD including PETD and PEID is a safe, effective and minimally invasive method to treat L5-S1 disc herniation.