Department of Orthopedic, Shanxian Central Hospital, Shanxian, China.
Eur Rev Med Pharmacol Sci. 2018 Jul;22(1 Suppl):103-110. doi: 10.26355/eurrev_201807_15371.
To investigate the clinical efficacy and safety of transforaminal endoscopic spine system (TESSYS) in treating the prolapse of lumbar intervertebral disc.
462 patients with prolapse of lumbar intervertebral disc who were treated in our hospital from June 2012 to May 2016 were enrolled. All patients were randomly divided into 2 groups: the study group (n=231) and the control group (n=231). Patients in the study group received TESSYS, while those in the control group received conventional surgical treatment with posterior approach. Venous blood was collected before the surgery and 6 h, 12 h, 24 h, and 48 h after surgery. C reactive protein (CRP), interleukin-6 (IL-6), creatine phosphokinase (CPK) and white blood cell (WBC) in each patient were measured. The operation time, intraoperative blood loss, length of stay, postoperative ambulation time and complications were compared between the two groups. Clinical efficacy before and after surgery (1st day, 1st month, 3rd month, and 6th month after surgery) was evaluated according to visual analogue scale (VAS), Oswestry disability index (ODI) and modified MacNab criteria.
The operation time, intraoperative blood loss, length of stay, postoperative ambulation time and complications of patients in the study group were less than those of the control group (p<0.05). There were no significant differences in VAS score and ODI score on the 1st day before surgery, 1st day, 1st, 3rd, and 6th month after surgery (p>0.05). According to the improved MacNab standard, the excellent and good rate was 87.88% in the study group and 84.85% in the control group, the difference was not statistically significant (p>0.05). There were no significant differences in CRP, IL-6, CPK and WBC between the two groups before surgery (p>0.05). Postoperative levels of CRP, IL-6, CPK, and WBC in study group were better than those in control group, the differences were statistically significant (p<0.05).
TESSYS has the advantages of less bleeding, less traumatic reactions, fewer complications, rapid postoperative recovery, and exact short-term effect in treatment for prolapse of lumbar intervertebral disc.
探讨经皮椎间孔内窥镜脊柱系统（TESSYS）治疗腰椎间盘突出症的临床疗效和安全性。
选取 2012 年 6 月至 2016 年 5 月我院收治的 462 例腰椎间盘突出症患者，将其随机分为研究组（n=231）和对照组（n=231）。研究组采用 TESSYS 治疗，对照组采用后路常规手术治疗。分别于术前及术后 6h、12h、24h、48h 采集静脉血，检测每位患者的 C 反应蛋白（CRP）、白细胞介素-6（IL-6）、肌酸磷酸激酶（CPK）和白细胞（WBC）。比较两组患者的手术时间、术中出血量、住院时间、术后下床活动时间和并发症。根据视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）和改良 MacNab 标准，评估两组患者术前、术后第 1 天、第 1 个月、第 3 个月和第 6 个月的临床疗效。
研究组患者的手术时间、术中出血量、住院时间、术后下床活动时间及并发症发生率均少于对照组（p<0.05）。两组患者术前、术后第 1 天、第 1 天、第 1 个月、第 3 个月和第 6 个月 VAS 评分和 ODI 评分比较差异均无统计学意义（p>0.05）。根据改良 MacNab 标准，研究组的优良率为 87.88%，对照组为 84.85%，差异无统计学意义（p>0.05）。两组患者术前 CRP、IL-6、CPK、WBC 比较差异均无统计学意义（p>0.05）。研究组术后 CRP、IL-6、CPK、WBC 水平优于对照组，差异有统计学意义（p<0.05）。
TESSYS 治疗腰椎间盘突出症具有出血量少、创伤反应小、并发症少、术后恢复快、短期疗效确切等优点。
