椎间孔镜maxMore技术治疗青少年腰椎间盘突出症

发布时间：2018-08-22 14:53

【摘要】：目的探讨经皮椎间孔镜maxMore技术治疗青少年腰椎间盘突出症的效果。方法 2009年6月~2015年5月对69例青少年单间隙腰椎间盘突出症采用经皮椎间孔镜maxMore技术,经后外侧入路进入椎管建立工作通道,经工作通道切除突出病变的髓核。采用视觉模拟评分法(visual analogue scale,VAS)、改良Oswestry指数(Oswestry disability index,ODI)简体中文版和Nakai评分标准进行评定。结果手术时间53~146 min,平均83 min;住院时间4~15 d,平均5.7 d。术后平均随访8.9月(6~15个月)。腰痛VAS术前评分中位数7分(3~9分),显著高于术后3个月中位数2分(0~5分)(Z=-8.883,P=0.000)和术后6个月中位数2分(0~5分)(Z=-8.934,P=0.000);下肢痛VAS术前评分中位数7分(4~9分),显著高于术后3个月中位数1分(0~6分)(Z=-9.369,P=0.000)和术后6个月中位数2分(0~5分)(Z=-9.504,P=0.000)。术前ODI为(48.7±11.5)%,显著高于术后3个月(14.6±6.7)%(P=0.000)和术后6个月(15.3±5.5)%(P=0.000)。根据Nakai评分标准,术后6个月优28例,良33例,可6例,差2例,优良率88.4%(61/69)。结论经皮椎间孔镜maxMore技术治疗青少年腰椎间盘突出症创伤小,疗效满意,是治疗青少年腰椎间盘突出症的理想手术方式。
[Abstract]:Objective to investigate the effect of percutaneous foramen maxMore in the treatment of adolescent lumbar disc herniation. Methods from June 2009 to May 2015, 69 cases of single space lumbar disc herniation in adolescents were treated by percutaneous transforaminal foramen (maxMore) technique. The spinal canal was established through the posterolateral approach and the nucleus pulposus was removed through the working pathway. Visual analogue scoring method (visual analogue scale), modified Oswestry index (Oswestry disability index) in simplified Chinese version and Nakai scoring standard were used. Results the operation time was 53 ~ 146 min (mean 83 min) and the hospitalization time was 4 ~ 15 d (average 5.7 d). The average follow-up was 8.9 months (6 ~ 15 months). The median preoperative score of VAS for low back pain was 7 (3 ~ 9), which was significantly higher than that of 3 months after operation (0 ~ 5) (Z) (0 ~ 5) and 6 months (0 ~ 5) after operation, and 7 (4 ~ 9) of VAS of lower extremity pain before operation, which was significantly higher than that of 3 postoperative patients. The median of 1 month (0 ~ 6 points) and 6 months after operation were 0 ~ 6 (0 ~ 6) (Z ~ (-9.369) P ~ (0.000) and 2 (0 ~ 5) after operation (Z ~ (-9.504) P ~ (0. 000). The preoperative ODI was (48.7 卤11.5)%, which was significantly higher than that at 3 months after operation (14.6 卤6.7)% (P0. 000) and 6 months after operation (15. 3 卤5. 5)% (P0. 000). According to Nakai score, 28 cases were excellent at 6 months after operation, 33 cases were good, 6 cases were fair and 2 cases were poor. The excellent and good rate was 88.4% (61 / 69). Conclusion Percutaneous transforaminal maxMore is an ideal surgical method for the treatment of adolescent lumbar disc herniation.
【作者单位】：解放军第113医院骨科;
【分类号】：R726.8

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