首页|经椎间孔镜下腰椎间盘髓核摘除术治疗腰椎间盘突出症

经椎间孔镜下腰椎间盘髓核摘除术治疗腰椎间盘突出症

The lumbar disc herniation treated with percutaneous endoscopic lumbar discectomy

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目的 探讨经椎间孔镜下腰椎间盘髓核摘除术(PELD)治疗腰椎间盘突出症的疗效.方法 采用PELD治疗50 例腰椎间盘突出症患者.记录并发症发生情况,采用疼痛VAS评分、ODI评分评价患者疼痛以及腰椎功能改善情况,采用改良MacNab标准评价疗效.结果 患者均获得 12 个月随访.术中发生硬膜囊撕裂1 例,出血1 例,类脊髓高压综合征2 例.术后发生1 例神经病理性疼痛.均未发生截瘫、感染等严重并发症.疼痛VAS评分、ODI评分术后各时间点均较术前降低(P<0.05);疼痛VAS评分术后1 个月与术后1d比较差异无统计学意义(P>0.05),术后3、6、12 个月均较术后1d降低(P<0.05);疼痛VAS评分及ODI评分术后3、6、12 个月均较术后1 个月降低(P<0.05),术后6、12 个月均较术后3 个月进一步降低(P<0.05),术后12 个月与术后6 个月比较差异均无统计学意义(P>0.05).术后12 个月采用改良MacNab标准评价疗效:优37 例,良10 例,可3 例,优良率94%.结论 PELD治疗腰椎间盘突出症可缓解患者疼痛,改善患者腰椎功能,疗效较好.
Objective To investigate the efficacy of percutaneous endoscopic lumbar discectomy(PELD)for the treat-ment of lumbar disc herniation.Methods Fifty patients with lumbar disc herniation were treated with PELD.The oc-currence of complications were recorded,pain VAS and ODI score were used to evaulate the status of patient′s pain and lumbar function improvement,and the effect was evaluated by using the improved MacNab standard.Results All patients were followed up for 12 months.During the operation,there was 1 case of dural sac tear,1 case of bleeding,and 2 cases of myeloid hypertension syndrome.Postoperative neuropathtic pain occurred in 1 case.No serious compli-cations such as paraplegia or infection occurred.The pain VAS and ODI score were both decreased at all time points after surgery,compared with before surgery(P<0.05).The pain VAS:there were no differences between postopera-tive 1 month and postoperative 1 d(P>0.05),while which was decreased at 3,6,12 months after surgery,compared with 1 d after surgery(P<0.05).The pain VAS and ODI score:they were both decreased at 3,6,and 12 months postoperation than postoperative 1 month(P<0.05),and further decreased at 6,12 months postoperatively,compared with 3 months postoperatively(P<0.05);there were no statistical differences between 12 months postoperatively and 6 months postoperatively(P>0.05).After 12 months of surgery,the modified MacNab standard was used to evaluate the efficacy:excellent in 37 cases,good in 10,fair 3,with an excellent-good rate of 94%.Conclusions PELD treat-ment of lumbar disc herniation can relieve pain,improve lumbar function,and have a good therapeutic effect.

percutaneous endoscopic lumbar discectomylumbar disc herniationmyeloid hypertension syndrome

张杰、方后山、王文亮、郭然、陈家平

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六安市中医院骨科,安徽 六安 237005

浙江省人民医院脊柱外科,浙江 杭州 310000

经椎间孔镜腰椎间盘切除术 腰椎间盘突出症 类脊髓高压综合征

国家自然科学基金青年基金

81901122

2024

临床骨科杂志
安徽医科大学,安徽省医学会

临床骨科杂志

CSTPCD
影响因子:1.438
ISSN:1008-0287
年,卷(期):2024.27(2)
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