经皮椎间孔镜下髓核摘除联合侧隐窝减压治疗对侧症状腰椎间盘突出症

发布时间：2018-04-23 21:21

本文选题：椎间孔镜 + 腰椎间盘突出症　；参考：《中国骨与关节损伤杂志》2016年05期

【摘要】：目的探讨经皮椎间孔镜下髓核摘除术(PELD)联合TESSYS侧隐窝减压治疗对侧症状腰椎间盘突出症的疗效及可行性。方法回顾性分析自2010-08—2015-05采用PELD联合TESSYS侧隐窝减压治疗的26例对侧症状腰椎间盘突出症。按骨钻打磨上关节突的次数分组,分为1次组、2或3次组、4次组。记录各组术前及术后2 d的下腰部、臀腿VAS评分,并比较疼痛改善程度。记录各组术前及术后3个月的JOA评分,比较JOA评分改善程度。末次随访时采用Macnab标准评定疗效。结果利用骨钻减压4次者8例,3次者7例,2次者4例,1次者7例。26例获得随访3~17个月,平均8个月。术后各组下腰部疼痛、臀腿部疼痛和JOA评分均较术前明显改善,差异有统计学意义(P0.05)。组间横向对比发现,1次组术前臀腿部VAS评分低于2或3次组和4次组,2或3次组疼痛缓解程度优于1次组,差异均有统计学意义(P0.05)。结论采用PELD联合TESSYS侧隐窝减压治疗对侧症状腰椎间盘突出症效果满意,安全有效。术中2或3次减压即可。
[Abstract]:Objective to investigate the efficacy and feasibility of percutaneous transurethral foramen discectomy (PELDL) combined with TESSYS lateral recess decompression in the treatment of contralateral lumbar disc herniation. Methods 26 patients with contralateral lumbar disc herniation treated with PELD combined with TESSYS lateral recess decompression were retrospectively analyzed. According to the times of grinding the upper articular process with bone drill, they were divided into two or three groups. The VAS scores of lower waist, hip and leg were recorded before and 2 days after operation, and the degree of pain improvement was compared. The JOA score before operation and 3 months after operation was recorded and the improvement of JOA score was compared. At the last follow-up, Macnab criteria were used to evaluate the efficacy. Results 8 cases were decompressed with bone drill 4 times, 3 times, 7 cases twice, 4 cases once, 7 cases 7 cases, 26 cases were followed up for 3 ~ 17 months, average 8 months. Postoperative pain in the lower waist, buttock and leg pain and JOA scores were significantly improved compared with those before operation (P 0.05). Transverse contrast between groups showed that the preoperative VAS score of the first group was lower than that of the group 2 or 3 and the pain relief of the group 2 or 3 was better than that of the first group, and the difference was statistically significant (P 0.05). Conclusion the treatment of contralateral lumbar disc herniation with PELD combined with TESSYS lateral recess decompression is safe and effective. Two or three times of decompression can be performed during the operation.
【作者单位】：中山大学孙逸仙纪念医院骨科;
【分类号】：R687.3

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