经皮椎间孔镜下射频热凝纤维环成形联合髓核摘除修复腰椎间盘突出症

背景：侧后路经椎间孔镜下椎间盘髓核摘除联合射频热凝纤维环成形术是治疗慢性椎间盘源性腰腿痛的微创治疗方法，尤其适合于极外侧型椎间盘突出。目的：探讨经皮椎间孔镜下髓核摘除联合射频热凝纤维环成形术治疗腰椎间盘突出症的安全性及近期疗效。方法：32例腰椎间盘突出症患者者，均应用侧后路经皮椎间孔镜髓核摘除联合射频热凝纤维环成形术治疗，治疗前后采用目测类比评分和改良Macnab标准评价患者腰痛缓解情况，ODI评分评价患者的日常生活情况，随访时间1-6个月，平均3.5个月。结果与结论：所有患者均顺利完成治疗，无神经血管系统损伤等并发症发生。患者腰痛及生活能力均获得明显的改善。与治疗前相比，治疗后患者目测类比评分评分及ODI评分明显改善（P 〈0.01）；参照Macnnab疗效评定标准，结果显示治疗后1周有效率达到94%，治疗后3月有效率为97%。说明经皮椎间孔镜下髓核摘除联合射频热凝纤维环成形术治疗腰椎间盘突出症近期疗效肯定，并发症少，近期功能恢复稳定。

Percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty for treatment of lumbar disc herniation

BACKGROUND：Percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty is a minimaly invasive therapy for chronic discogenic low back pain, especialy suitable for lumbar disc herniation. OBJECTIVE：To evaluate the safety and short-term efficacy of percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty for treatment of lumbar disc herniation. METHODS：Thirty-two patients with lumbar disc herniation were subjected to percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty. Visual analogue scale and modified Macnab criteria were used to evaluate the relief of low back pain, and the Oswestry Disability Index was used for daily life evaluation of patients. Al the patients were folowed for 1-6 months, with an average of 3.5 months. RESULTS AND CONCLUSION：The operation was successfuly completed in al patients, and no complications such as damage to nerve and vascular systems occurred. Low back pain and living ability of the patients were improved obviously. Visual analog scale score and the Oswestry Disability Index were improved significantly after operation （P 〈 0.01）; according to Macnnab＇s criteria, the results showed that at 1 week after the operation, the effective rate reached 94%; at 3 months after the operation, the effective rate was up to 97%. These findings indicate that percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty in the treatment of lumbar disc herniation is confirmed in the short-term efficacy, and characterized as fewer complications and stable functional recovery.