经皮内镜下腰椎间盘切除术治疗青少年腰椎间盘突出症:46例连续患者的手术结果
Percutaneous endoscopic lumbar discectomy for adolescent lumbar disc herniation: surgical outcomes in 46 consecutive patients.
作者信息
Lee Dong Yeob, Ahn Yong, Lee Sang-Ho
机构信息
Department of Neurosurgery, Gimpo Airport Wooridul Spine Hospital, 47-4 Chungdam-dong Kangnam-gu, 135-100, Seoul, Republic of Korea.
出版信息
Mt Sinai J Med. 2006 Oct;73(6):864-70.
BACKGROUND
The surgical outcome of percutaneous endoscopic lumbar discectomy (PELD) for adolescent lumbar disc herniation has rarely been reported on. We performed this study to evaluate the surgical outcome of PELD for adolescent lumbar disc herniation.
METHODS
We analyzed the surgical outcomes in 46 consecutive adolescent patients between 13 and 18 years of age (mean age, 16.5 years) who underwent PELD for single level lumbar disc herniation from June 2000 to May 2002. Using the clinical charts and mailed questionnaires, we evaluated the patients preoperatively by the postoperative Visual Analogue Scale (VAS) for back and leg pain, and by the postoperative Macnab criteria.
RESULTS
PELD was performed at L3-4 on one patient, at L4-5 on 40 patients and at L5-S1 on 5 patients. One patient complained of transient dysesthesia after the operation. Another patient underwent subsequent open discectomy because only incomplete decompression was achieved with PELD. At a mean follow-up duration of 37.2 months (range: 25-48 months), the mean VAS scores of both the back and leg pain decreased significantly. In terms of the Macnab criteria, 91.3% of the patients showed excellent or good outcomes. Recurrent disc herniation developed in one patient 14 months after surgery.
CONCLUSIONS
Adolescents who underwent PELD for single level soft lumbar disc herniation showed favorable results that were comparable to the results of open discectomy.
背景
经皮内镜下腰椎间盘切除术(PELD)治疗青少年腰椎间盘突出症的手术疗效鲜有报道。我们开展本研究以评估PELD治疗青少年腰椎间盘突出症的手术疗效。
方法
我们分析了2000年6月至2002年5月期间连续46例年龄在13至18岁(平均年龄16.5岁)因单节段腰椎间盘突出症接受PELD手术的青少年患者的手术疗效。通过临床病历和邮寄问卷,我们采用术后视觉模拟评分法(VAS)评估患者术前及术后的腰腿痛情况,并依据术后Macnab标准进行评估。
结果
1例患者在L3 - 4节段接受PELD手术,40例患者在L4 - 5节段,5例患者在L5 - S1节段。1例患者术后出现短暂感觉异常。另1例患者随后接受了开放性椎间盘切除术,因为PELD仅实现了不完全减压。平均随访37.2个月(范围:25 - 48个月),腰腿痛的平均VAS评分均显著降低。根据Macnab标准,91.3%的患者显示出优或良的结果。1例患者在术后14个月出现复发性椎间盘突出。
结论
因单节段软性腰椎间盘突出症接受PELD手术的青少年显示出良好的效果,与开放性椎间盘切除术的效果相当。