Wang Xiandi, Zeng Jiancheng, Nie Hongfei, Chen Guo, Li Zhuhai, Jiang Hushan, Kong Qingquan, Song Yueming, Liu Hao
Department of Orthopedic Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang St, 610041, Chengdu, Sichuan, People's Republic of China.
Childs Nerv Syst. 2014 May;30(5):897-902. doi: 10.1007/s00381-013-2320-4. Epub 2013 Nov 29.
Percutaneous endoscopic interlaminar discectomy (PEID) is a widely used minimally invasive procedure which shows satisfying outcomes in the adult population. However, pediatric lumbar disc herniations (PLDH) occur in growing spines and are less related to degeneration, which makes them different from the adult disc herniations. This study evaluates the clinical outcomes of PEID in treating PLDH.
A prospect study was done in the period from June 2010 to December 2012, which included 29 consecutive pediatric patients with a mean age of 16.4 years (range, 13 to 18 years) who underwent PEID for single level lumbar disc herniation. The following measuring tools were used: visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and Macnab criteria.
There were no severe complications such as dural tear or nerve root damage found in our study. The mean follow-up period was 19.7 months. The VAS score for leg and back pain decreased dramatically at 1 day postoperatively and kept decreasing until the follow-up visit at 3 months postoperatively, when it became stable at a low level. ODI kept improving until the follow-up visit at 6 months postoperatively when it reached a stable low level. Of the patients, 91% reported no longer having leg pain and 9% had occasional leg pain at last follow-up.
PEID shows a satisfying outcome with a minimal rate of complications. It has the advantages of minimal traumatization and scar formation and is a safe and effective treatment for PLDH.
经皮内镜下椎间孔切开椎间盘切除术(PEID)是一种广泛应用的微创手术,在成人患者中显示出令人满意的效果。然而,小儿腰椎间盘突出症(PLDH)发生于正在生长的脊柱,与退变关系较小,这使其与成人椎间盘突出症有所不同。本研究评估PEID治疗PLDH的临床效果。
2010年6月至2012年12月进行了一项前瞻性研究,纳入29例连续的小儿患者,平均年龄16.4岁(范围13至18岁),因单节段腰椎间盘突出症接受PEID治疗。使用了以下测量工具:背部和腿部疼痛的视觉模拟量表(VAS)、Oswestry功能障碍指数(ODI)和Macnab标准。
本研究中未发现硬膜撕裂或神经根损伤等严重并发症。平均随访期为19.7个月。术后1天腿部和背部疼痛的VAS评分显著下降,并持续下降直至术后3个月随访时稳定在低水平。ODI持续改善直至术后6个月随访时达到稳定的低水平。在最后随访时,91%的患者报告不再有腿部疼痛,9%的患者偶尔有腿部疼痛。
PEID显示出令人满意的效果,并发症发生率极低。它具有创伤小和瘢痕形成少的优点,是治疗PLDH的一种安全有效的方法。