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经横突旁入路椎间孔镜治疗髂嵴高的 L5-S1 腰椎间盘突出症。

Treatment of high-iliac-crest L5-S1 lumbar disc herniation via a transverse process endoscopic transforaminal approach.

机构信息

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Neurospine Center, China International Neuroscience Institute, 100530, Beijing, People's Republic of China.

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Neurospine Center, China International Neuroscience Institute, 100530, Beijing, People's Republic of China.

出版信息

Clin Neurol Neurosurg. 2020 Oct;197:106087. doi: 10.1016/j.clineuro.2020.106087. Epub 2020 Jul 15.

Abstract

OBJECTIVE

To investigate the clinical efficacy of transverse process endoscopic transforaminal discectomy for the treatment of high-iliac-crest L5-S1 lumbar disc herniation.

METHODS

Seventeen patients with high-iliac-crest L5-S1 lumbar disc herniation who were treated with transforaminal endoscopy from April 2016 to January 2019 in the Department of Neurosurgery of Xuanwu Hospital were selected. The visual analog scale (VAS) and Oswestry disability index (ODI) were used to evaluate the efficacy of the procedure.

RESULTS

All of the patients successfully underwent the surgical treatment. Sixteen patients (94.1 %) completed effective follow-up for more than 12 months. The VAS was 7.8 ± 1.9, 2.9 ± 1.6, 2.3 ± 1.5 and 2.2 ± 1.6 before surgery and at one day, 3 months, and the last follow-up after surgery, respectively. The ODI scores were 52.8 ± 15.2 and 16.9 ± 9.7 before surgery and 3 months after surgery, respectively, both of which were lower than before surgery (both P < 0.01).

EFFICACY EVALUATION

An excellent outcome was achieved in 13 (81.3 %) patients, a good outcome in 1 patient (6.3 %), an acceptable outcome in 1 patient (6.3 %), and a poor outcome in 1 patient (6.3 %).

CONCLUSIONS

The transverse process endoscopic transforaminal discectomy is a safe and effective surgical method for the treatment of high-iliac-crest L5-S1 lumbar disc herniation.

摘要

目的

探讨经横突间入路椎间孔镜治疗髂嵴高 L5-S1 腰椎间盘突出症的临床疗效。

方法

选取 2016 年 4 月至 2019 年 1 月在宣武医院神经外科接受经椎间孔内镜治疗的 17 例髂嵴高 L5-S1 腰椎间盘突出症患者,采用视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评估疗效。

结果

所有患者均成功完成手术治疗。16 例(94.1%)患者获得 12 个月以上的有效随访。患者术前 VAS 评分为(7.8±1.9)分,术后 1 天、3 个月、末次随访时分别为(2.9±1.6)分、(2.3±1.5)分、(2.2±1.6)分;术前 ODI 评分为(52.8±15.2)分,术后 3 个月时为(16.9±9.7)分,均低于术前(均 P<0.01)。

疗效评估

优 13 例(81.3%),良 1 例(6.3%),可 1 例(6.3%),差 1 例(6.3%)。

结论

经横突间入路椎间孔镜治疗髂嵴高 L5-S1 腰椎间盘突出症安全有效。

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