摘要
[目的]探讨单切口镜下椎间盘切除术治疗青壮年双节段腰椎间盘突出症的临床疗效。[方法]回顾性分析2014年3月~2018年12月本科诊治的34例青壮年双节段腰椎间盘突出症患者的临床资料。依据医患沟通分为两组,内镜组18例,采用单切口经皮脊柱内镜经椎间孔入路摘除椎间盘;开放组16例,采用后路椎板开窗摘除椎间盘。比较两组围手术期、随访与影像资料。[结果]内镜组出血量、切口长度、切口愈合时间均显著优于开放组(P<0.05)。随时间延长,两组VAS、ODI和JOA评分显著改善(P<0.05)。术后1个月及末次随访时,内镜组上述评分均显著优于开放组(P<0.05)。影像方面,术后两组椎管占位率均较术前明显改善(P<0.05)。术后1个月和末次随访时开放组的椎管占位率显著优于内镜组(P<0.05),末次随访时,内镜组的椎间隙高度显著优于开放组(P<0.05)。[结论]单切口经皮脊柱内镜下治疗青壮年双节段腰椎间盘突出症创伤小、疗效理想。
[Objective]To explore the clinical outcomes of percutaneous transforaminal endoscopic discectomy(PTED)through a single incision for double-segment lumbar disc herniations in young adults by comparison with open discectomy.[Methods]From March 2014 to December 2018,a total of 34 young adults underwent surgical treatment for adjacent doublesegment lumbar disc herniations in our department.Based on the consequence of patient-doctor communication,18 patients received PTEDs through a single small incision,while the remaining 16 patients underwent conventional open discectomy.The perioperative,follow-up and imaging documents were compared between the two groups.[Results]The PTED group proved significantly superior to the open group regarding to intraoperative blood loss,incision length and healing time of incision(P<0.05).The VAS,ODI and JOA scores significantly improved over time in both groups(P<0.05),which were significantly superior in the PTED group to the open group at 1 month postoperatively and the latest follow up(P<0.05).In term of imaging assessment,the space-occupying rate of spinal canal significantly improved in both groups after operation compared with those before operation(P<0.05),which in the open group were superior to the PTED group at 1 month postoperatively and the latest follow up(P<0.05).However,the PTED group remained significantly superior intervertebral space height to the open group at the latest follow up(P<0.05).[Conclusion]The PTEDs through a single small incision does achieve satisfactory clinical outcomes for adjacent double-segment lumbar disc herniations in young adults with benefits of minimizing iatrogenic trauma and improving functional recovery.
作者
尤瑞金
于海霞
杨德育
吕宏升
YOU Rui-jin;YU Hai-xia;YANG De-yu;LV Hong-sheng(Orthopaedic Department,The 910th Hospital of PLA,Quanzhou 362000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2020年第15期1366-1370,共5页
Orthopedic Journal of China
基金
泉州市科技计划项目(编号:2018Z138)。
关键词
双节段椎间盘突出症
经皮椎间孔镜椎间盘切除术
开放椎间盘切除术
adjacent double-segment lumbar disc herniations
percutaneous transforaminal endoscopic discectomy
open discectomy
作者简介
尤瑞金,副主任医师,研究方向:脊柱与关节外科,(电话)13459528800,(电子信箱)13959729666@163.com。
