经皮椎间孔镜与Quadrant微创通道下治疗腰椎间盘突出症的临床研究

发布时间：2018-08-19 17:02

【摘要】：目的比较经皮椎间孔镜(PTED)和Quadrant微创通道下手术治疗腰椎间盘突出症(LDH)的临床疗效。方法将59例单节段LDH患者,随机分为PTED组和Quadrant组。其中,PTED组31例,Quadrant组28例。对两组手术时间、切口长度、失血量、住院天数、返回工作时间及手术并发症进行对比分析。采用视觉疼痛模拟评分(VAS)、日本骨科学会下腰痛评分标准(JOA)、Oswestry功能障碍指数(ODI)及改良Mac Nab标准评价手术疗效。结果 PTED组与Quadrant组相比手术切口小、术中出血量少、住院天数及返回工作时间上明显缩短(P0.05),术后两组患者的VAS、JOA和ODI评分得到改善(P0.05);而且术后3天、1和3个月,PTED组VAS腰痛评分低于相应时间Quadrant组评分(P0.05);两组在术后各随访时间点的JOA和ODI评分无明显差异(P0.05)。按照改良Mac Nab标准评定,两组间优良率差异无统计学意义(P0.05)。结论 PTED和Quadrant通道两种微创术式治疗LDH均能取得满意的临床效果,但PTED手术恢复快、创伤更小。
[Abstract]:Objective To compare the clinical effects of percutaneous transforaminal endoscopy (PTED) and Quadrant minimally invasive approach in the treatment of lumbar disc herniation (LDH).Methods 59 patients with single-level LDH were randomly divided into PTED group and Quadrant group.31 patients in PTED group and 28 patients in Quadrant group. Operative complications were compared and analyzed. Visual analogue pain scale (VAS), Japanese Orthopedic Association low back pain score (JOA), Oswestry dysfunction index (ODI) and modified Mac Nab were used to evaluate the surgical outcomes. The VAS, JOA and ODI scores of the two groups were improved (P 0.05), and the VAS low back pain score of PTED group was lower than that of Quadrant group at 3 days, 1 and 3 months after operation (P 0.05); there was no significant difference in JOA and ODI scores between the two groups at each follow-up time point (P 0.05). Conclusion Both PTED and Quadrant channel minimally invasive surgery can achieve satisfactory clinical results in the treatment of LDH, but PTED has a faster recovery and less trauma.
【作者单位】：广州医科大学附属第六医院骨科一区;
【基金】：广东省医学科学技术研究基金项目(No:A2015222)
【分类号】：R687.3

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