椎间孔镜下“可视化椎间孔成形技术”治疗腰椎间盘突出症的安全性及临床疗效分析

探讨“可视化椎间孔成形技术”治疗腰椎间盘突出症的安全性及临床疗效。 方法 收集行椎间孔入路经皮内镜下髓核摘除术的患者71例,分为2组:经典TESSYS技术组29例(对照组)及可视化椎间孔成形技术组42例(观察组)。观察并记录治疗前、治疗过程中及治疗后的相关指标,并行统计学分析。 结果 2组患者的年龄、性别、腰椎间盘突出类型、术前VAS评分及Oswestry功能障碍指数(ODI)差别均无统计学意义(P>0.05); 手术操作时间、术中C臂透视次数,观察组均明显低于对照组(P<0.01); 2组患者术后住院时间、随访时间、末次随访时的VAS评分及ODI评分比较差别均无统计学意义(P>0.05)。根据改良Macnab评定标准评定优良率,对照组29例中,优22例、良5例、可2例,优良率93.1%; 观察组42例中,优31例、良8例、可3例,优良率为92.9%,2组比较,差别无统计学意义(P>0.05)。 结论 椎间孔镜下“可视化椎间孔成形技术”治疗腰椎间盘突出症安全、有效,与经典的TESSYS技术比较,具有操作简便、手术时间短、放射暴露少的优点。

Percutaneous Endoscopic Lumbar Discectomy byVisible Foraminoplasty Approach for Lumbar Disc Herniation

Objective To explore the clinical efficacy of percutaneous endoscopic lumbar discectomy by visible foraminoplasty approach for lumbar disc herniation. Methods From January 2015 to June 2016, a total of 71 patients were divided to control group(TESSYS approach 29 cases)and observation group(visible foraminoplasty approach 42 cases). Both groups were followed up by using the following measurements, and the treatment effect of the two groups was compared. Results There was no significant difference in sex, age, herniation type, postoperative bed rest time, and length of hospital stay between two groups(P>0.05). There was no difference in preoperative or last follow-up VAS, ODI scores between two groups(P>0.05). The average follow-up time of control group and observation group was(9.2±1.9)months and(9.5±2.1)months respectively, which showed no difference between two groups(P>0.05). Observation group had less operation time and intraoperative fluoroscopy times than control group(P<0.01). The satisfaction rate of modified Macnab classification in control group was 93.1% in control group and 92.9% in observation group, and there was no difference between two groups(P>0.05). Conclusion The percutaneous endoscopic lumbar discectomy by visible foraminoplasty approach are equal to the TESSYS approach for the LDH in clinical results but the former is superior in less operation time and less radiation exposure.