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经皮内镜下腰椎间盘切除术与开放式显微椎间盘切除术的放射学对比评估:一项匹配队列分析。

Comparative radiologic evaluation of percutaneous endoscopic lumbar discectomy and open microdiscectomy: a matched cohort analysis.

作者信息

Lee Sang-Ho, Chung Seung-Eun, Ahn Yong, Kim Tae-Hong, Park Jee-Young, Shin Song-Woo

机构信息

Department of Neurosurgery, Wooridul Spine Hospital, 47-4 Chungdam-dong, Kangnam-gu, Seoul, Korea.

出版信息

Mt Sinai J Med. 2006 Sep;73(5):795-801.

Abstract

BACKGROUND

Only a few studies comparing percutaneous endoscopic discectomy and open discectomy have been reported in the literature. The purpose of this study was to compare the radiographic changes in patients treated with percutaneous endoscopic lumbar discectomy (PELD) with those of patients treated with open lumbar microdiscectomy (OLM).

METHODS

A total of 30 patients who underwent PELD with a minimum three years of follow-up were randomly selected. To compare with the PELD group, 30 patients who underwent OLM during the same period were also randomly selected according to sex, age, and disc level. The clinical outcomes were evaluated by the Macnab criteria. Statistical analysis was performed using independent sample t-test, paired sample t-test, chi-square test, Fisher's exact test, and analysis of variance (ANOVA).

RESULTS

The successful clinical outcomes were 96.7% in the PELD group and 93.3% in the OLM group. Among the various radiological parameters, changes of disc height (1.41 +/- 1.19 mm in the PELD group and 2.29 +/- 2.12 mm in the OLM group, p=0.024) and foraminal height (1.26 +/- 0.91 mm in the PELD group and 1.85 +/- 0.92 mm in the OLM group, p=0.017) were significantly different between the two groups.

CONCLUSIONS

Although the clinical outcomes were similarly satisfactory in both groups, PELD is a less invasive procedure than open microdiscectomy in s elected cases.

摘要

背景

文献中仅有少数关于经皮内镜椎间盘切除术与开放椎间盘切除术对比的研究报道。本研究的目的是比较经皮内镜腰椎间盘切除术(PELD)治疗的患者与开放腰椎显微椎间盘切除术(OLM)治疗的患者的影像学变化。

方法

随机选取30例行PELD且至少随访3年的患者。为与PELD组进行比较,根据性别、年龄和椎间盘节段,随机选取同期行OLM的30例患者。采用Macnab标准评估临床疗效。使用独立样本t检验、配对样本t检验、卡方检验、Fisher精确检验和方差分析(ANOVA)进行统计分析。

结果

PELD组的成功临床疗效为96.7%,OLM组为93.3%。在各项放射学参数中,两组间椎间盘高度变化(PELD组为1.41±1.19mm,OLM组为2.29±2.12mm,p = 0.024)和椎间孔高度变化(PELD组为1.26±0.91mm,OLM组为1.85±0.92mm,p = 0.017)存在显著差异。

结论

尽管两组的临床疗效均同样令人满意,但在特定病例中,PELD是一种比开放显微椎间盘切除术侵入性更小的手术。

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