摘要
目的 对比分析经皮椎间孔镜与后路椎间盘切除椎间融合钉棒内固定术在治疗腰椎间盘突出症中的疗效.方法 回顾性分析2014年9月至2015年9月144例椎间盘突出症患者的临床资料.根据手术方式的不同分为两组,采用后路椎间盘切除椎间融合钉棒内固定术者为开放组（80例）,经皮椎间孔镜手术（TESSYS）者为椎间孔镜组（64例）.分别统计两组的手术时间、出血量、术后卧床时间、住院时间.采用疼痛视觉模糊评分（VAS）、Oswestry功能障碍指数（ODI）评定疗效.结果 144例患者手术全部顺利完成,术后均获随访9~12个月,平均10.8个月.椎间孔镜组手术时间、术中出血量、术后住院时间、切口长度均低于开放组（P均〈0.05）;两组患者术后3 d、3、6、9个月VAS评分均低于术前,差异有统计学意义（P〈0.05）;且两组间术后各随访时间点的ODI指数差异有统计学意义（P〈0.05）.结论 经皮椎间孔镜和后路椎间盘切除椎间融合钉棒内固定术均可有效治疗椎间盘突出症,前者手术创伤更小,术后恢复更快,并发症少,但手术学习曲线较长,并需要选择合适的适应证.
Objective To compare the clinical effects of posterior lumbar interbody fusion with pedicle screw fixation discectomy and percutaneous transforaminal endoscopic spine system on lumbar disc herniation.Methods From September 2014 to September 2015, the clinical data of 144 patients with lumbar disc herniation by surgical treatment were retrospectively analyzed.A total of 64 patients were treated by percutaneous transforaminal endoscopic spine system, 80 patients were treated by posterior lumbar interbody fusion with pedicle screw fixation discectomy.The operative time, amount of bleeding, postoperative bed time, duration of hospitalization were compared.The clinical therapeutic results were evaluated by visual analogue scale（VAS） assessment and oswestry disability index（ODI）.Results All of the 144 patients had successful surgery.The average follow-up duration was 10.8 months, ranged from 9 to 12 months.In TESSYS group, the operation time, intraoperative bleeding volume, postoperative hospital stay and length of incision were significantly lower than those in the open operation group （all P 〈0.05）.At 3 days, 3 months, 6 months and 9 months after operation, VAS scores were lower than those before operation in the two groups（all P 〈0.05）.The levels of postoperative ODI were significantly improved compared with preoperative in the two groups, there were significant differences （P all 〈0.05）.Conclusions The posterior lumbar interbody fusion with pedicle screw fixation discectomy and percutaneous transforaminal endoscopic spine system are very good for treatment of lumbar disc hemiation, the latter has less operative trauma, faster recovery after surgery, fewer complications, but surgical learning curve is longer, and need to select the appropriate indications.
出处
《中国实用医刊》
2017年第14期49-51,共3页
Chinese Journal of Practical Medicine
关键词
腰椎间盘突出症
经椎间孔内窥镜脊柱系统
外科手术
疗效
Lumbar disc herniation
Percutaneous transforaminal endoscopic discectomy
Surgical procedures
Efficacy
作者简介
通信作者：马俊豪，Email：1872120696@qq．com.
