PIED治疗髓核游离型椎间盘突出的手术策略和临床疗效

发布时间：2018-03-23 21:16

本文选题：PIED　切入点：髓核游离　出处：《南京医科大学学报(自然科学版)》2017年09期

【摘要】：目的 :评价椎间孔镜下经椎板间入路椎间盘摘除术(percutaneous interlaminar endoscopic discectomy,PIED)治疗髓核游离型椎间盘突出的疗效。方法:2014年1月—2015年12月接受PIED手术治疗髓核游离型椎间盘突出患者11例,并获得完整随访资料,随访时间为1年,通过术前、术后1 d、术后1年的视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability inde,ODI)及改良Mac Nab标准评价患者术后腰腿痛改善情况以及术前术后腰椎MRI对比评价髓核摘除效果及复发情况。结果:11例患者手术成功率为100%。术前腰痛VAS(7.00±1.00)分,术后1 d疼痛明显缓解,VAS(0.55±0.52)分,术后1年VAS(0.36±0.50)分;术前平均ODI为(58.55±6.07)%,术后1 d(4.54±2.25)%,术后1年为(1.09±1.04)%;改良Macnab标准评估手术总体结果,所有患者接受手术后症状均基本缓解,恢复了正常工作与生活,优良率达到100%;术后游离的髓核均被完全摘除,无复发椎间盘突出者。结论:PIED能有效治疗髓核游离型椎间盘突出,标准的PIED手术可以获得满意的治疗效果。
[Abstract]:Objective: to evaluate the efficacy of percutaneous interlaminar endoscopic discectomytomyd (PIED) in the treatment of free disc herniation of nucleus pulposus by translaminar intervertebral discectomy under transforaminal foramen. Methods: from January 2014 to December 2015, 11 patients with free disc herniation of nucleus pulposus were treated with PIED. Complete follow-up data were obtained. The follow-up time was 1 year. Visual analogue scale and Oswestry disability index (Oswestry disability index) and modified Mac Nab standard were used to evaluate the improvement of postoperative lumbago and leg pain and the preoperative and postoperative MRI to evaluate the effect of nucleus pulposus excision and recurrence. Results the successful rate of operation in 11 cases was 100%. The score of preoperative low back pain was 1. 00 卤1. 00. The mean ODI was 58.55 卤6.07 before operation, 4.54 卤2.25 on 1 day after operation, and 1.09 卤1.04 on 1 year after operation. The modified Macnab standard was used to evaluate the overall outcome of the operation, and the symptoms of all the patients were basically relieved after operation. The free nucleus pulposus was removed completely after operation, and no recurrent disc herniation was found. Conclusion the free disc herniation of nucleus pulposus can be effectively treated by 1: PIED. The standard PIED procedure can achieve satisfactory results.
【作者单位】：南京医科大学第一附属医院骨科;
【基金】：国家自然科学基金(81371970)
【分类号】：R687.3

【相似文献】