经皮内镜腰椎间盘切除术与显微椎间盘切除术治疗腰椎间盘突出症：疼痛、功能障碍及并发症发生率——一项随机临床试验
Percutaneous Endoscopic Lumbar Discectomy Versus Microdiscectomy for the Treatment of Lumbar Disc Herniation: Pain, Disability, and Complication Rate-A Randomized Clinical Trial.
作者信息
Meyer Guilherme, DA Rocha Ivan Dias, Cristante Alexandre Fogaça, Marcon Raphael Martus, Coutinho Thiago Pereira, Torelli Alessandro Gonzalez, Petersen Pedro Araujo, Letaif Olavo Biraghi, DE Barros Filho Tarcísio Eloy Pessoa
机构信息
Spine Surgery Division, Instituto de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo, FMUSP, São Paulo, Brazil.
Spine Surgery Division, Instituto Vita, São Paulo, Brazil.
出版信息
Int J Spine Surg. 2020 Feb 29;14(1):72-78. doi: 10.14444/7010. eCollection 2020 Feb.
PURPOSE
The objective was to compare the traditional microdiscectomy with percutaneous endoscopic lumbar discectomy for the treatment of disc herniations regarding pain, disability, and complications.
METHODS
Randomized clinical trial with 47 patients with disc herniations treated with 2 different surgical techniques: traditional microdiscectomy or percutaneous endoscopic lumbar discectomy. Forty-seven patients were divided into 2 groups and monitored for 12 months. Irradiated and low back pain were evaluated with the visual analog scale. Surgery complications were recorded.
RESULTS
After surgery, the sciatica and disability improved significantly but without significant differences between the groups. Improvements in back pain were significant until the third month. There were no statistical differences between groups regarding recurrence, infection, and the need for reoperation.
CONCLUSIONS
Endoscopic discectomy results are similar to those of conventional microdiscectomy regarding pain and disability improvement. Postoperative lumbar pain is less intense with endoscopic discectomy than conventional microdiscectomy only during the first 3 months. Endoscopic discectomy is a safe and efficient alternative to microdiscectomy.
CLINICAL TRIALS
Trial protocol registration number: RBR-5symrd (http://www.ensaiosclinicos.gov.br).
目的
比较传统显微椎间盘切除术与经皮内镜下腰椎间盘切除术治疗椎间盘突出症在疼痛、功能障碍及并发症方面的差异。
方法
对47例椎间盘突出症患者进行随机临床试验，采用两种不同的手术技术治疗：传统显微椎间盘切除术或经皮内镜下腰椎间盘切除术。47例患者分为两组，随访12个月。采用视觉模拟量表评估坐骨神经痛和腰痛情况。记录手术并发症。
结果
术后，坐骨神经痛和功能障碍均有显著改善，但两组间无显著差异。腰痛在术后第三个月前有显著改善。两组在复发、感染及再次手术需求方面无统计学差异。
结论
在内镜下椎间盘切除术与传统显微椎间盘切除术在改善疼痛和功能障碍方面效果相似。仅在术后前3个月，内镜下椎间盘切除术所致的术后腰痛较传统显微椎间盘切除术轻。内镜下椎间盘切除术是显微椎间盘切除术的一种安全有效的替代方法。
临床试验
试验方案注册号：RBR-5symrd（http://www.ensaiosclinicos.gov.br）。
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