经皮内镜椎板间入路椎间盘切除术治疗伴有钙化的L5S1腰椎间盘突出症15例报告及文献复习

目的：探讨经皮内镜椎板间入路椎间盘切除术（PEID）治疗伴有钙化的腰5骶1（L5S1）腰椎间盘突出症的临床效果和治疗策略。方法：选取15例伴有钙化的L5S1腰椎间盘突出症患者，采用PEID结合内镜下可变向动力系统进行治疗。检测患者术前、术后1d、术后1周、术后3个月和术后6个月的视觉模拟评分（VAS）及Oswestry功能障碍指数（ODI）。术后6个月应用改良Macnab评分评价患者的疗效。结果：术后1 d、术后1周、术后3个月和术后6个月患者VAS和ODI评分明显低于术前（P<0.05）；改良Macnab评分显示优良率为86.67%；术后复查影像学可见术前患者的椎间盘钙化区域均被有效地清除，神经根减压良好，无神经根损伤、脑脊液漏和感染等并发症。结论：PEID结合内镜下可变向动力系统能够有效治疗伴有钙化的L5S1腰椎间盘突出症，具有创伤小、手术时间短和康复时间短的特点。

Treatment of calcified L5S1 lumbar disc herniation with percutaneous endoscopic interlaminar discectomy:A report of 15 cases and literature review

Objective: To investigate the clinical effect and treatment strategy of percutaneous endoscopic interlaminar discectomy(PEID) in the treatment of calcified L5S1 lumbar disc herniation. Methods: A total of 15 patients with calcified L5S1 lumbar disc herniation were selected and treated with PEID combined with variable power system.The Visual Analogue scale (VAS) and Oswestry dysfunction index (ODI) scores of the patients were evaluated before operation,and 1 d,1 week,3 months,6 months after operation.Macnab score was used to evaluate the curative effect of the patients 6 months after operation. Results: The scores of VAS and ODI of the patients 1 d,1 week,3 months, and 6 months after operation were significantly lower than those before operation (P<0.05);the modified Macnab score showed that the excellent and good rate was 86.67%;the postoperative image results showed that the calcification area of intervertebral disc was removed,the nerve root was decompressed effectively,and there were no nerve root injury,cerebrospinal fluid leakage and infection. Conclusion: PEID combined with variable power system can effectively treat the calcified L5S1 lumbar disc herniation with the advantages of less trauma,short operation time and short recovery period.