Wu Guan-Nan, Zhang Shi-Min, Jin Jiao, Sun Bi-Qian
The First Department of Spinal Surgery, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China.
The First Department of Spinal Surgery, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China;
Zhongguo Gu Shang. 2017 Sep 25;30(9):861-865. doi: 10.3969/j.issn.1003-0034.2017.09.016.
To explore the clinical effects of percataneous endoscopic lumbar discectomy for lumbar intervertebral disc protrusion.
The clinical data of 46 patients with lumbar intervertebral disc protrusion underwent percataneous endoscopic lumbar discectomy were retrospectively analyzed. There were 21 males and 25 females, aged from 23 to 65 years old with an average of 42 years. The course of disease was from 5 to 87 months with an average of 13.4 months. Protrusion located in L₂,₃ of 2 cases, L₃,₄ of 3 cases, L₄,₅ of 28 cases, L₅S₁ of 13 cases. There were 5 patients with central type, 34 with para-side type, 7 with extreme lateral type. VAS, ODI and JOA scores were used to analyze the condition of pain releasing and lumbar functional improvement. According to MacNab standard to evaluate the clinical effect at final follow-up.
All the operations were successful, operative time was 125 to 210 min with a mean of 153.6 min; and all the patients were follow-up for 6 to 12 months with an average of 8 months; no injuries of nerve and blood vessel, infection were found. Postoperative 3 days and final follow-up, VAS score was 3.1±0.7, 2.2±0.6 respectively, and was obviously lower than preoperative 7.3±1.2(<0.05). At final follow-up, JOA and ODI were (23.5±2.4) points, and (22.10±9.26)%, respectively, and was obviously improved compared with preoperative (13.2±2.8) points and (69.12±13.15)% (<0.05). According to modified MacNab standard to evaluate the clinical outcome, 30 cases got excellent results, 14 good, 2 fair, no recurred and overhauling were found.
Percataneous endoscopic lumbar discectomy is a minimally invasive technique, with advantage of safety and effectiveness, and apply to treatment of lumbar intervertebral disc protrusion.
探讨经皮内镜下腰椎间盘切除术治疗腰椎间盘突出症的临床效果。
回顾性分析46例行经皮内镜下腰椎间盘切除术的腰椎间盘突出症患者的临床资料。其中男21例，女25例，年龄23～65岁，平均42岁。病程5～87个月，平均13.4个月。突出部位：L₂₃ 2例，L₃₄ 3例，L₄₅ 28例，L₅S₁ 13例。中央型5例，旁侧型34例，极外侧型7例。采用视觉模拟评分法（VAS）、腰椎功能障碍指数（ODI）和日本骨科学会评估法（JOA）分析疼痛缓解及腰椎功能改善情况。末次随访时根据MacNab标准评估临床疗效。
所有手术均获成功，手术时间125～210分钟，平均153.6分钟；所有患者均获随访6～12个月，平均8个月；未发现神经、血管损伤及感染等并发症。术后3天及末次随访时VAS评分分别为3.1±0.7、2.2±0.6，明显低于术前的7.3±1.2（P<0.05）。末次随访时JOA评分为（23.5±2.4）分，ODI为（22.10±9.26）%，与术前（13.2±2.8）分和（69.12±13.15）%相比明显改善（P<0.05）。根据改良MacNab标准评估临床疗效，优30例，良14例，可2例，无复发及翻修病例。
经皮内镜下腰椎间盘切除术是一种微创手术，具有安全、有效的优点，适用于腰椎间盘突出症的治疗。
