内镜下髓核摘除联合纤维环修复治疗腰椎间盘突出症
Clinical Efficacy of Annulus Fibrosus Repair affter Discectomy under Endoscopic Treatment of Lumbar Disc Herniation
刘彬 1张廷伟 1刘永强 1李佳佳 1姜泽威 1王利君 1谭远超 1周纪平1
作者信息
- 1. 山东省文登整骨医院(山东文登,264400)
- 折叠
摘要
目的:探讨采用内镜下髓核摘除联合纤维环修复治疗腰椎间盘突出症(LDH)的临床疗效.方法:纳入2021年1月至2023年1月收治腰椎间盘突出症患者82例,其中采用单纯内镜下髓核摘除手术治疗47例(对照组),采用内镜下髓核摘除联合纤维环修复治疗35例(修复组).记录手术时间及术中出血量,记录术前、术后10 d及术后3,6,12,18个月Oswestry功能障碍指数(ODI)、腰痛和下肢痛的视觉模拟量表(VAS)评分,观察两组手术并发症及术后复发情况.结果:两组手术均顺利完成,且获得完整随访,修复组手术时间高于对照组(P＜0.05),两组术中出血量差异无统计学意义(P＞0.05),两组间术后各时间点复查腰腿痛VAS评分和ODI差异无统计学意义(P＞0.05),两组术后各时间点复查腰腿痛VAS评分和ODI较术前明显改善,差异有统计学意义(P＜0.05).两组均未发生硬膜囊撕裂、术后感染、椎管内血肿压迫等严重并发症.对照组复发率为8.51％(其中30.4％再次手术),修复组无复发及再手术者.结论:采用内镜下髓核摘除联合纤维环修复治疗腰椎间盘突出症可获得显著的早期临床效果,可降低术后复发和再次手术的风险.
Abstract
Objective:Exploring the clinical efficacy of using endoscopic nucleus pulposus removal combined with annulus fibrosus repair for the treatment of lumbar disc herniation(LDH).Methods:82 patients with LDH were enrolled from January 2021 to January 2023.Among them,47 patients were treated with simple full visual endoscopic nucleus pulposus removal surgery(control group),and 35 patients were treated with total endoscopic nucleus pulposus removal combined with annulus fibrosus repair(repair group).The surgical time and intraoperative bleeding were recorded,and Oswestry dysfunction index(ODI),visual analogue scale(VAS)scores of low back pain and lower limb pain were recorded before,10 d after surgery,and 3,6,12,and 18 months after surgery.Observe the surgical complications and postoperative recur-rence in two groups.Results:Both groups of surgeries were successfully completed and received complete follow-up.The repair group had a longer surgical time than the control group(P＜0.05),and there was no statistically significant differ-ence in intraoperative bleeding between the two groups(P＞0.05).There was no statistically significant difference in the VAS score and ODI at each postoperative time point between the two groups(P＞0.05).The VAS score and ODI at each postoperative time point in the two groups were significantly improved compared to before surgery,and the difference was statistically significant(P＜0.05).Both groups did not experience serious complications such as dural sac tear,postoperative infection,and compression of spinal hematoma.The recurrence rate in the control group was 8.51％,of which 30.4％underwent surgery again.There was no recur-rence or reoperation cases in the repair group.Conclusion:The use of endoscopic nucleus pulposus removal combined with annulus fibrosus repair for the treatment of lumbar disc herniation can achieve significant early clinical results,effectively reducing the risk of postoperative recurrence and reoperation.
关键词
纤维环修复/脊柱内镜/髓核摘除/微创/椎间盘突出Key words
annulus fibrosus repair/spinal endoscopy/nucleus pulposus removal/minimally invasive/intervertebral disc herniation引用本文复制引用
基金项目
第七批全国老中医药专家传承项目(国中医药人教函[2022]76号)
山东省医药卫生项目(202204070548)
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据