经皮椎间孔镜治疗腰椎间盘突出伴后纵韧带骨化的临床研究

发布时间：2018-03-23 02:31

本文选题：后纵韧带骨化　切入点：腰椎间盘突出症　出处：《中国矫形外科杂志》2017年19期 　论文类型：期刊论文

【摘要】：[目的]探讨经皮椎间孔镜治疗腰椎间盘突出伴后纵韧带骨化的临床效果及手术技巧。[方法]收集本院2014年12月~2016年11月收治的腰椎间盘突出伴后纵韧带骨化患者共计10例,均行经皮侧方椎间孔镜技术进行治疗。平均病程26.5个月,平均随访时间10.2个月。分别于术前及术后1 d、3个月和末次随访时行视觉疼痛模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)和改良Mac Nab疗效评定对临床疗效进行分析评估,对患者术前和末次随访时X线片、CT和MRI影像学资料进行比较,并统计手术时间、术中出血量、术后并发症、住院时间等资料。[结果]腰痛VAS评分从术前的(8.46±0.23)降至末次随访的(1.12±0.19)分;腿痛VAS评分从术前的(8.68±0.22)分降至末次随访的(1.05±0.25)分;ODI评分分别从术前(81.25±2.86)分降至末次随访的(13.25±1.38)分。末次随访时,依据改良的Mac Nab标准评估,优良率达90%。[结论]经皮椎间孔镜技术可有效治疗腰椎椎间盘突出伴后纵韧带骨化,使神经根得到及时彻底减压及松解,临床效果显著。
[Abstract]:[Objective] to investigate the percutaneous transforaminal endoscopic discectomy for treatment of lumbar disc herniation with posterior lumbar surgery. The clinical effect and skills] method of longitudinal ligament collected in our hospital in December 2014 ~2016 year in November from disc herniation associated with ossification of posterior longitudinal ligament in patients with a total of 10 cases underwent percutaneous lateral transforaminal endoscopic technique treatment. The average duration of 26.5 months, the average follow-up time was 10.2 months. Before and after surgery to 1 D, 3 months and at the last follow-up visual analogue score (visual analogue, scale, VAS), Oswestry disability index (Oswestry disability index, ODI) and modified Mac Nab to analyze and evaluate the clinical curative effect evaluation effect of preoperative and last follow-up X-ray film, CT and MRI imaging data were compared, and the operation time, intraoperative blood loss, postoperative complications, hospitalization time and other information. The low back pain VAS score from preoperative (8.46 + 0.23) At the end of the follow-up to the (1.12 + 0.19); leg pain VAS score from preoperative (8.68 + 0.22) points to the last follow-up (1.05 + 0.25); ODI score from preoperative (81.25 + 2.86) points to the last follow-up (13.25 + 1.38) points at the end of the follow-up. When evaluated according to the modified Mac Nab criteria, the excellent rate was 90%.[Conclusion] percutaneous transforaminal endoscopic surgery is effective in the treatment of lumbar disc herniation with ossification of the posterior longitudinal ligament, the nerve root decompression and timely release, the clinical effect is significant.

【作者单位】：山东省日照市第二人民医院骨科;泰山医学院附属医院骨科;
【分类号】：R687.3

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