摘要
[目的]探讨CT定位内镜椎间盘切除术(CT guided endoscopic discectomy, CTED)治疗高龄腰椎间盘突出症的临结果。[方法] 2010年6月—2020年6月采用CTED治疗年龄≥75岁的高龄腰椎间盘突出症患者88例,记录围手术期指标采用VAS、ODI评分和腰椎JOA评分,以及Mac Nab标准评价临床疗效,CT测量手术前后突出物面积变化。[结果]所有患均顺利完成手术,无严重术中并发症,无合并症诱发或病情加重。所有患者均获随访6~126个月,随时间推移,VAS和OD评分显著减少(P<0.05),而JOA评分显著增加(P<0.05)。末次随访按Mac Nab标准评定,优58例,良20例,优良88.64%。CT影像测量,突出物面积由术前(102.95±44.06) mm2显著减少至术后1周(20.73±14.16) mm2(P<0.05)。[结论]CT定位内镜椎间盘切除术治疗高龄腰椎间盘突出症具有创伤小、安全性好、术后恢复快等优点,可取得满意疗效。
[Objective] To investigate the clinical outcomes of CT guided endoscopic discectomy(CTED) for lumbar disc herniation in the elderly. [Methods] From June 2010 to June 2020, a total of 88 patients who aged≥75 years underwent CTED for lumbar intervertebral disc herniation. Perioperative documents were collected;VAS, ODI and JOA scores, as well as Mac Nab’s criteria were used for evaluation of the clinical outcomes;additionally, CT scans were conducted to measure the changes of protrusion area before and after the operation.[Results] All patients had CTED completed successfully without serious intraoperative complications, and no comorbidities induced or aggravated. All patients were followed up for 6 to 126 months. The VAS and ODI scores decreased significantly(P<0.05), while the JOA score increased significantly over time(P<0.05). According to the Mac Nab’s criteria, the clinical outcomes were graded as excellent in 58 cases, good in 20 cases, with the excellent and good rate of 88.64%. In term of CT image measurement, the protrusion area significantly reduced from(102.95±44.06) mm2 before operation to(20.73±14.16) mm2 1 week after operation(P<0.05). [Conclusion] The CTED has the advantages of less trauma, good safety, quick recovery after operation, and does achieve satisfactory outcomes for the treatment of lumbar disc herniation in the elderly.
作者
孙海涛
魏帅帅
韩大鹏
马宗雷
张洪涛
周大鹏
宫子阳
关家文
SUN Hai-tao;WEI Shuai-shuai;HAN Da-peng;MA Zong-lei;ZHANG Hong-tao;ZHOU Da-peng;GONG Zi-yang;GUAN Jia-wen(Department of Spine Surgery,Shandong Armed Police Corps Hospital,Jinan 250014,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第13期1229-1232,共4页
Orthopedic Journal of China
作者简介
孙海涛,副主任医师,研究方向:脊柱外科,(电话)15053177714,(电子信箱)sdwjspine@163.com。
