Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Shanghai 200233, China.
Department of Diagnostic and Interventional Radiology, Department of Orthopedics, Dandong Center Hospital, Liaoning, China.
J Vasc Interv Radiol. 2019 Jun;30(6):894-899. doi: 10.1016/j.jvir.2018.12.018. Epub 2019 Apr 2.
To determine the safety and efficacy of percutaneous lumbar discectomy (PLD) and percutaneous disc cementoplasty (PDCP) for painful lumbar disc herniation (LDH) in patients >60 years of age.
Sixteen older patients (mean age, 71.00 ± 6.24 years) with painful LDH were treated with PLD and PDCP. The outcome data (the Macnab criteria, visual analog scale score, and Oswestry disability index) were collected preoperatively; at 1 week postoperatively; at posttreatment months 1, 3, and 6; and every 6 months thereafter. In addition, treatment duration, injection volume of bone cement, length of hospital stay, and complications were assessed.
Treatment was successful in all patients. The pain relief rate at the last follow-up was 87.5%. Six, 8, and 2 patients showed excellent, good, and fair results, respectively; no patient showed a poor result. The average visual analog scale for back and leg pain decreased from 6.75 ± 1.06 and 7.00 ± 0.89 before the procedure to 2.81 ± 1.60 and 2.87 ± 1.75 at 1 month, 2.79 ± 1.58 and 2.71 ± 1.64 at 6 months, and 2.90 ± 1.73 and 3.00 ± 1.76 at 1 year, respectively. The scores were 2.44 ± 1.63 and 2.44 ± 1.71, respectively, at the last follow-up. The Oswestry disability index also changed after the procedure, with significant differences between baseline scores and those at each follow-up (P < .001). The mean procedure duration, injection volume of bone cement, and length of hospital stay were 55.69 ± 5.86 minutes, 2.50 ± 0.63 mL, and 7.06 ± 2.41 days, respectively. There were no complications.
The combination of PLD and PDCP is feasible, safe, and effective for older patients with painful LDH.
评估经皮腰椎间盘切除术（PLD）联合经皮椎间盘骨水泥成形术（PDCP）治疗 60 岁以上伴疼痛的腰椎间盘突出症（LDH）患者的安全性和有效性。
对 16 例 60 岁以上伴疼痛的 LDH 患者行 PLD 联合 PDCP 治疗。术前、术后 1 周、治疗后 1、3、6 个月及此后每 6 个月收集 Macnab 标准、视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）等疗效数据。同时评估手术时间、骨水泥注射量、住院时间和并发症。
所有患者均获得成功治疗。末次随访时，疼痛缓解率为 87.5%。6、8、2 例患者的疗效分别为优、良、可，无一例差。VAS 评分腰背疼痛分别由术前的 6.75±1.06、7.00±0.89 降至术后 1 个月的 2.81±1.60、2.87±1.75，术后 6 个月的 2.79±1.58、2.71±1.64，术后 1 年的 2.90±1.73、3.00±1.76，末次随访时分别为 2.44±1.63、2.44±1.71。ODI 评分术后亦有改善，与术前相比差异均有统计学意义（P＜0.001）。手术时间、骨水泥注射量、住院时间分别为 55.69±5.86min、2.50±0.63mL、7.06±2.41d。无并发症发生。
PLD 联合 PDCP 治疗 60 岁以上伴疼痛的 LDH 患者是可行、安全且有效的。
