经皮椎板间内镜治疗腰椎间盘突出症临床疗效观察

发布时间：2018-01-13 00:10

本文关键词：经皮椎板间内镜治疗腰椎间盘突出症临床疗效观察　出处：《中华全科医学》2016年07期 　论文类型：期刊论文

【摘要】：目的评价和总结经皮椎板间入路使用椎间孔镜(percutaneous transforaminal endoscopic discectomy,PTED)治疗特定性腰椎间盘突出症的症状改善及安全性指标,从而为特定性椎间盘突出症患者寻找合理的治疗方法。方法回顾性分析于2012~2014年在骨科诊断为腰椎间盘突出症并给予经皮椎板间入路使用椎间孔镜治疗的患者共计51例。使用电话、电子邮件、门诊随访等方式对患者的术中及术后各因素进行详实准确的随访,在患者的VAS疼痛改善、腰椎功能及生存质量提高等方面进行综合的评估和总结。对所有患者均进行至少6个月标准化的术后随访,并在术后及术后6个月就观察指标进行观察。结果所有患者在术后及术后6个月疼痛情况较前均有明显改善,差异均具有统计学意义(P0.05)。患者的Lehmann腰椎功能评分和SF-36生存质量评分均较术前亦有明显改善,差异均具有统计学意义(P0.05)。在手术疗效方面,所有患者术后6个月时对其MacNab疗效进行评估,其优良率为92.1%。结论对于符合手术适应证的腰椎间盘突出患者,使用经皮椎板间入路椎间孔镜治疗相对安全,可实现微创治疗,并收到良好的治疗效果,患者的疼痛、功能和生活质量较术前均有明显的改善,在临床工作中可以进一步的使用和推广。
[Abstract]:Objective to evaluate and summarize the use of intervertebral foramen through percutaneous interlaminar approach. Percutaneous transforaminal endoscopic discectomy. PTED) treatment of specific lumbar disc herniation symptom improvement and safety indicators. Methods from 2012 to 2014, the patients with specific intervertebral disc herniation were diagnosed as lumbar disc herniation in orthopedic department and the intervertebral foramina was used by percutaneous interlaminar approach. A total of 51 patients were treated by endoscopy. E-mail, outpatient follow-up and other methods to patients during and after the detailed and accurate follow-up of the various factors, in patients with VAS pain improvement. The lumbar function and quality of life were evaluated and summarized. All patients were followed up for at least 6 months. The observation indexes were observed after operation and 6 months after operation. Results the pain status of all patients was significantly improved after operation and 6 months after operation. The difference was statistically significant (P 0.05). The scores of Lehmann lumbar function and SF-36 quality of life were also significantly improved compared with those before operation. The difference was statistically significant (P 0.05). In terms of surgical efficacy, all patients were evaluated for MacNab at 6 months after operation. The excellent and good rate is 92.1.Conclusion for the patients with lumbar disc herniation, percutaneous interlaminar approach is relatively safe and can achieve minimally invasive treatment. The patients' pain, function and quality of life were significantly improved compared with those before operation, and could be further used and popularized in clinical work.
【作者单位】：陕西省榆林市星元医院(榆林市第四医院)骨科;第四军医大学唐都医院骨科;
【基金】：国家自然科学基金(81201633)
【分类号】：R687.3
【正文快照】： 腰椎间盘突出(lumbar disc herniation,LDH)是目前导致中老年人出现腰腿疼的主要原因[1],随着工作、生活方式的改变,其发病年龄有越来越小的趋势[2]。其经典的治疗方式为后路开放手术治疗,这种手术方式疗效确切,减压彻底,但创伤大,出血多,并且对脊柱稳定性造成极大破坏,并不适

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