经皮椎间孔镜腰椎间盘切除术与开窗腰椎间盘切除术治疗腰椎间盘突出症的疗效对比

发布时间：2018-01-28 06:40

本文关键词： 经皮椎间孔镜腰椎间盘切除术开窗腰椎间盘切除术腰椎间盘突出症　出处：《颈腰痛杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的比较经皮椎间孔镜腰椎间盘切除术与开窗腰椎间盘切除术治疗腰椎间盘突出症(LDH)的近期临床疗效。方法回顾性分析2014-01-2015-01期间在我科接受手术治疗的单节段LDH患者80例,其中接受经皮椎间孔镜腰椎间盘切除术(PTED)患者40例,接受开窗腰椎间盘切除术患者40例.比较两种手术切口长度、手术时间、出血量、住院天数等情况。手术效果按照视觉疼痛模拟评分(visual analogue scale,VAS)、改良Mac Nab标准进行评定。结果 PTED组及开窗腰椎间盘切除术组的切口长度、出血量、住院天数比较,差异均有统计学意义(P0.05),手术时间差异无统计学意义(P0.05)。两组患者术后随访时间平均12个月,PTED组术前及术后各个随访点VAS评分与开窗组相比较,差异无统计学意义(P0.05),两组术后各随访时间点腰腿痛VAS评分较术前均明显改善(P0.05)。PTED组和开窗腰椎间盘切除术患者末次随访时按改良Macnab标准评定,优良率分别为:、92.5%和90%,组间比较差异无统计学意义(P0.05)。结论 PTED与开窗腰椎间盘切除术治疗单节段腰椎间盘突出症均可取得满意的近期临床疗效。但PTED具有创伤小、出血少和恢复快等[8]特点,是更为理想的微创手术方法。
[Abstract]:Objective to compare the treatment of lumbar disc herniation with percutaneous foraminal discectomy and fenestration of lumbar intervertebral disc herniation (LDH). Methods 80 patients with single segment LDH who received surgical treatment in our department during 2014-01-2015-01 were analyzed retrospectively. Among them, 40 patients underwent percutaneous transhepatic lumbar discectomy (PTED) and 40 patients underwent fenestration of lumbar intervertebral discectomy. The length, duration and bleeding of the two kinds of incision were compared. According to visual pain simulation score, visual analogue scaleVAS. etc. Results there were significant differences in incision length, bleeding volume and hospitalization days between PTED group and fenestration group (P 0.05). There was no significant difference in operation time between the two groups (P 0.05). The average follow-up time of the two groups was 12 months. The VAS scores at each follow-up point before and after operation were compared with those in the windowed group. The difference was not statistically significant (P0.05). The VAS score of low back and leg pain at different time points after operation in both groups was significantly improved compared with that before operation. The patients in P0.05 group and fenestration group were evaluated according to the modified Macnab standard at the last follow-up. The excellent and good rates were 92.5% and 90%, respectively. There was no significant difference between the two groups (P0.05). Conclusion both PTED and fenestration in the treatment of single segment lumbar disc herniation can obtain satisfactory short-term clinical effect, but PTED has little trauma. Less bleeding and faster recovery. [It is a more ideal method of minimally invasive surgery.
【作者单位】：潍坊医学院;解放军第89医院;
【分类号】：R687.3
【正文快照】： 在临床中,腰椎间盘突出症是常见疾病,随着微创脊柱外科技术的发展,通过椎间孔镜下椎间盘切除术治疗腰椎间盘突出症日趋成熟。本院应用椎间孔镜工作系统采用BEIS(Broad Easy Immediate Surgery)技术治疗腰椎间盘突出症40例,对比开窗腰椎间盘切除术疗效满意,报道如下。 1材料和

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