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完全内镜下经椎间孔腰椎间盘切除术:163 例手术治疗患者的短期临床结果。

Fully endoscopic interlaminar and transforaminal lumbar discectomy: short-term clinical results of 163 surgically treated patients.

机构信息

Department of Neurosurgery, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.

Department of Neurosurgery, Artvin State Hospital, Artvin, Turkey.

出版信息

World Neurosurg. 2014 Nov;82(5):884-90. doi: 10.1016/j.wneu.2014.05.032. Epub 2014 Jun 4.

Abstract

OBJECTIVE

To evaluate the clinical outcomes of patients with lumbar disc disease undergoing fully endoscopic surgery at a single clinic.

METHODS

Between August 2009 and January 2012, 163 patients (74 men and 89 women) underwent fully endoscopic lumbar discectomy. All patients were followed for 1 year after surgery. The Oswestry Disability Index and a visual analog scale were used to analyze outcomes.

RESULTS

During the follow-up period, 114 (70%) patients had no complaints, 30 (18%) patients had occasional pain, and 19 (12%) patients had no improvement. During postoperative follow-up, 8 patients required repeat surgery for recurrence or residual fragments. Postoperatively, 4 patients experienced dysesthesia, which completely resolved in time. Neurologic deterioration occurred in 5 patients, 4 of whom recovered completely without any intervention. Dural tears occurred in 6 patients.

CONCLUSIONS

Fully endoscopic interlaminar or transforaminal surgeries are safe and effective treatment modalities for lumbar disc herniations. Despite the difficulties of acquiring this new technique, good results can be achieved with sufficient experience.

摘要

目的

评估单家诊所行全内镜手术治疗腰椎间盘疾病患者的临床疗效。

方法

2009 年 8 月至 2012 年 1 月,共 163 例患者(74 名男性,89 名女性)行全内镜下腰椎间盘切除术。所有患者术后随访 1 年。采用 Oswestry 功能障碍指数和视觉模拟评分评估疗效。

结果

随访期间,114 例(70%)患者无任何不适,30 例(18%)患者偶有疼痛,19 例(12%)患者无改善。术后随访时,8 例患者因复发或残留碎片需再次手术。术后 4 例患者出现感觉异常,均及时完全缓解。5 例患者出现神经功能恶化,其中 4 例未经任何干预完全恢复。6 例患者发生硬脊膜撕裂。

结论

全内镜经皮侧隐窝或椎间孔入路手术是治疗腰椎间盘突出症的安全有效方法。尽管掌握这项新技术有一定难度,但只要经验丰富,就能取得良好的效果。

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