经椎板间入路全内镜手术治疗钙化型腰椎间盘突出症的临床疗效观察

发布时间：2018-03-04 10:29

本文选题：腰椎间盘突出症　切入点：钙化型　出处：《遵义医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨经椎板间入路全内镜手术(Full endoscopic technique,FET)治疗钙化型腰椎间盘突出症的临床疗效。方法:收集我院脊柱外科从2014年8至2016年11月收治钙化型腰椎间盘突出症的患者15例,采用经椎板间入路全内镜手术治疗,记录患者手术时间、术中出血量、术中并发症、术后复发及术后住院时间等情况,随访6个月,分别比较患者术前与术后1d、术后3个月及术后6个月的功能障碍指数(Oswestry Disability Index,ODI)、视觉模拟评分(Visual Analogue Scale,VAS),采用术后3个月MacNab改良的疗效评价评估手术疗效,所有患者均行腰椎正侧位片、腰椎电子计算机断层扫描(Computed tomography,CT)及磁共振成像(Magnetic resonance imaging,MRI)检查。结果:本组病例中,手术时间在77-101分钟,平均手术时间为88分钟,术中无明显出血,所有病例均在内镜下顺利完成,无术中并发症的发生,随访至今所有病例无一例出现术后复发,术后住院时间为2-3天;术前ODI指数为82.5±5.0,术后1天、术后3个月、6个月ODI指数分别为27.1±3.4、24.1±3.5、22.4±2.5,术前ODI指数分别与术后1天、3个月及6个月ODI指数比较,差异均有统计学意义(P0.05),术后1天ODI指数分别与术后3个月及术后6个月ODI指数比较,差异均有统计学意义(P0.05);术前VAS评分为7.8±0.7,术后1天、术后3个月、术后6个月VAS评分分别为2.5±0.7、2.0±0.5、1.5±0.5,术前VAS评分分别与术后1天、术后3个月及6个月VAS评分比较,差异均有统计学意义(P0.05),术后1天VAS评分分别与术后3个月及术后6个月VAS评分比较,差异均有统计学意义(P0.05);术后3月根据改良MacNab标准疗效评价,优12例、良2例、可1例、差0例,优良率93.3%(14/15);术后CT及MRI提示突出钙化的椎间盘组织被切除。结论:经椎板间入路全内镜手术治疗钙化型腰椎间盘突出症具有短期疗效确切、出血量少、手术时间短、并发症少、术后康复快等特点。
[Abstract]:Objective: to investigate the clinical effect of full endoscopic technique (FET) through interlaminar approach in the treatment of calcified lumbar disc herniation. Methods: from 2014 to November 2016, 15 patients with calcified lumbar disc herniation in our hospital were collected. Patients were treated with total endoscopy via interlaminar approach. The time of operation, blood loss, complications, postoperative recurrence and postoperative hospital stay were recorded and followed up for 6 months. Oswestry Disability index index (Oswestry Disability index) and visual analogue score (VAS) were compared between preoperative and postoperative 1 day, 3 months after operation and 6 months after operation respectively. Three months after operation, the modified MacNab was used to evaluate the outcome of the operation. All the patients were given Lumbar Lumbar anterior and lateral radiographs. Results: the operation time was 77-101 minutes, the average operation time was 88 minutes, there was no obvious bleeding during the operation, all cases were successfully completed under endoscope. No intraoperative complications occurred, no recurrence occurred in all cases, the postoperative hospitalization time was 2-3 days, the preoperative ODI index was 82.5 卤5.0, and the postoperative ODI index was 1 day after operation. The ODI index at 3 months and 6 months after operation was 27.1 卤3.4 卤3.5 卤22.4 卤2.5, respectively. The ODI index of preoperative ODI was significantly higher than that of 1 day, 3 months and 6 months after operation (P 0.05). The ODI index of 1 day after operation was compared with that of 3 months after operation and 6 months after operation. The difference was statistically significant (P < 0.05), the preoperative VAS score was 7.8 卤0.7, the VAS score at 1 day, 3 months after operation and 6 months after operation was 2.5 卤0.7 卤0.5 卤0.5, respectively. The VAS score before operation was compared with that at 1 day, 3 months and 6 months after operation, respectively. The difference was statistically significant (P 0.05), the VAS score on the 1st day after operation was significantly higher than that at 3 months and 6 months after operation (P 0.05), and on March, according to the modified MacNab standard, 12 cases were excellent, 2 cases were good, 1 case was fair. After operation, CT and MRI showed that calcified intervertebral disc was excised. Conclusion: the treatment of calcified lumbar disc herniation by total endoscopy via interlaminar approach is effective in the short term, with less bleeding and shorter operation time. Few complications and quick recovery after operation.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

【相似文献】