Singh Ratish, Zeng Xin Gao, Hirachan Mangal Prasad, Yu Cheng Lin
Department of Spine Surgery, Zhongda Hopital, Medical School of Southeast University, Nanjing, China.
Asian Spine J. 2018 Jun;12(3):511-517. doi: 10.4184/asj.2018.12.3.511. Epub 2018 Jun 4.
Retrospective study.
To evaluate the outcome of percutaneous transforaminal endoscopic lumbar surgery (PTELS) and to evaluate the efficacy of this technique in the treatment of lumbar disc herniation (LDH) and lumbar spine stenosis (LSS) in >60-year-old patients.
There has been number of studies done in aspect of PTELS. All those studies focused on overall clinical aspect with no any age specific analysis. This articles deals with the patient >60 years old with low back pain (LBP) treated with the PTELS. This study provides the details of clinical outcome after the surgery in those age group.
We retrospectively studied 77 patients aged >60 years; out of these, 45 patients presented with LDH and 22 patients with lumbar spinal stenosis who underwent PTELS.
The mean age of the patients who underwent the surgery was 68.33±6.97 years and the mean duration of the surgery and the postoperative duration of hospitalization were 87.31±24.746 minutes and 3.79±2.711 days, respectively [corrected]. The pre- and postoperative Oswestry Disability Index were 52.8022±11.98299 and 16.3513±12.97398 ( <0.05), respectively, indicating statistical significance. The pre- and postoperative visual analogue scale scores of the leg and back were 6.27±1.213 and 4.79±1.162 ( <0.05) and 1.40±1.688 and 1.30±1.436, respectively ( <0.05), which showed a significant difference. Based on the MacNab criteria, 76.1%, 10%, and 6% of the patients showed excellent or good, fair, and poor outcomes, respectively. Incomplete removal of content and reherniation were observed in 3% and 7.5% of the patients. No significant difference was found between the clinical outcomes of PTELS between LDH and LSS.
PTELS can be a good technique in spine surgery to relieve symptoms for LBP with satisfactory outcome, short duration of hospitalization, and advantages such as elimination of general anesthesia in elderly patients.
回顾性研究。
评估经皮椎间孔镜腰椎手术（PTELS）的疗效，并评价该技术在治疗60岁以上患者腰椎间盘突出症（LDH）和腰椎管狭窄症（LSS）中的有效性。
在PTELS方面已经进行了多项研究。所有这些研究都集中在整体临床方面，没有任何针对特定年龄的分析。本文探讨了接受PTELS治疗的60岁以上腰痛（LBP）患者。本研究提供了该年龄组手术后临床结果的详细信息。
我们回顾性研究了77例年龄大于60岁的患者；其中，45例为腰椎间盘突出症患者，22例为腰椎管狭窄症患者，均接受了PTELS手术。
接受手术患者的平均年龄为68.33±6.97岁，平均手术时间和术后住院时间分别为87.31±24.746分钟和3.79±2.711天[校正后]。术前和术后Oswestry功能障碍指数分别为52.8022±11.98299和16.3513±12.97398（P<0.05），具有统计学意义。术前和术后腿部及背部的视觉模拟量表评分分别为6.27±1.213和4.79±1.162（P<0.05）以及1.40±1.688和1.30±1.436（P<0.05），显示出显著差异。根据MacNab标准，分别有76.1%、10%和6%的患者显示出优或良、一般和差的结果。分别有3%和7.5%的患者观察到内容物清除不完全和复发。腰椎间盘突出症和腰椎管狭窄症患者PTELS的临床结果之间未发现显著差异。
PTELS可能是脊柱手术中一种较好的技术，可缓解腰痛症状，结果令人满意，住院时间短，并且具有避免老年患者全身麻醉等优点。
