经皮椎间孔镜下腰椎手术治疗腰椎间盘突出和腰椎管狭窄的临床效果

发布时间：2023-03-04 04:49

　　背景:腰椎间盘突出症和腰椎管狭窄症是最常见的年龄相关性脊柱疾病。经皮椎间孔镜下腰椎手术是目前治疗该疾病最新的微创手术方式。目的:探讨经皮椎间孔镜下腰椎手术对腰痛患者的治疗效果,并进一步评价该手术对不同年龄段、不同性别及不同诊断的腰痛患者的疗效差异。材料与方法:该回顾性研究共纳入257例2013至2017年于我院行经皮椎间孔镜下腰椎手术的患者,其中腰椎间盘突出症患者206例,腰椎管狭窄症患者51例,在这257例患者中,男性153例,女性104例;年龄≤55岁151例,年龄>55岁106例。平均随访时间为19.78月。结果:入组患者平均手术时间为80.12±23.91分钟,平均住院时间为4.33±1.94天。术前和术后的ODI指数有明显差异(56.27±15.23,8.94±11.06,p<0.05)。术前、术后下肢VAS评分(6.70±1.15,0.83±1.30,p<0.05)、背部VAS评分(5.83±1.44,0.73±1.18,p<0.05),均有显著差异。参照MacNab标准评价,79.4%的患者疗效满意,14%的患者疗效一般,6.6%的患者疗效较差。通...

【文章页数】：93 页

【学位级别】：硕士

【文章目录】：
ACKNOWLEDGEMENT
DEDICATION
ABSTRACT
摘要
PREFACE
ABBREBIATIONS
CHAPTER 1: INTRODUCTION
    1.1. Overview
        1.1.1. Lumbar Disc Herniation
        1.1.2. Lumbar Spine Stenosis
        1.1.3. Background of Percutaneous Endoscopic Lumbar Spine Surgery
    1.2. The Purpose of the Research
CHAPTER 2: LITERATURE REVIEW
    2.1. Anatomy of Vertebral body
        2.1.1. Vertebral Body
        2.1.2. Intervertebral disc
        2.1.3. Spinal Ligaments
        2.1.4. Spinal Nerve
        2.1.5. Other structures
    2.2. Low Back Pain
        2.2.1. Overview
        2.2.2. Sign and symptoms
        2.2.3. Causes
        2.2.4. Pathophysiology
        2.2.5. Diagnosis
        2.2.6. Management
    2.3. Literature Discussion:
        2.3.1. Percutaneous Transforaminal Endoscopic Lumbar Spine Surgery for Lumbar Disc Herniation
        2.3.2. Percutaneous Transforaminal Endoscopic Lumbar Spine Surgery for Lumbar Stenosis
CHAPTER 3: RESEARCH ANALYSIS
    3.1. Research Design and methodology
        3.1.1. Research Design, Method and Data collection:
        3.1.2. Population, Sample and Sampling Techniques
        3.1.3. Statistical Analysis
    3.2. Surgical Procedure (Percutaneous Transforaminal Endoscopic Lumbar Spine Surgery)
        3.2.1. Surgical Equipment/Instruments
        3.2.2. Surgical (Transforaminal) Technique:
    3.3. Clinical Evaluation
        3.3.1. The Oswestry Disability Index (ODI) [142]
        3.3.2. A Visual Analogue Scale (VAS) [144]
        3.3.3. Macnab criteria[144]
    3.4. Result and Data Interpretation
        3.4.1. Overall analysis on preoperative and postoperative patient’s conditions treated with transforaminal approach
        3.4.2. Analysis of preoperative and postoperatively patient’s conditions on the basis of gender.
        3.4.3. Analysis of clinical outcome between LDH and LSS cases treated with transforaminal approach
55 years old age undergone PTELS with transforaminal approach">        3.4.4. Analysis of clinical outcome of patients of ￡55years old and >55 years old age undergone PTELS with transforaminal approach
    3.5. DISCUSSION
    3.6. CONCLUSION
REFERENCE



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