Department of Orthopaedics, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi City, China.
Department of Orthopaedics, The First People's Hospital Affiliated to Suzhou University, Suzhou City, China.
Orthop Surg. 2021 Feb;13(1):63-70. doi: 10.1111/os.12831. Epub 2020 Dec 3.
The aim of this study was to compare the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) and percutaneous endoscopic transforaminal discectomy (PETD) in treating L /S disc herniation.
A retrospective analysis of 76 patients with L /S intervertebral disc herniation was performed. There were two surgical treatment groups: one with patients receiving PEID and the other with patients receiving PETD. The two groups were compared by length of surgery, times of intraoperative X-ray exposure, postoperative time in bed, length of hospital stay, operative complications, patient's assessment of pain using a visual analogue scale (VAS), and disability using the Oswestry disability index (ODI) before and after surgery.
Subjects in the PEID group were in surgery for 60.90 ± 13.11 min and needed intraoperative X-ray exposure 4.10 ± 1.09 times. Patients in this group were ambulatory by 7.52 ± 1.08 h after surgery and were hospitalized for 5.05 ± 0.92 days. In contrast, patients in the PETD group were in surgery for 84.06 ± 15.58 min and needed intraoperative X ray exposure 12.81 ± 8.46 times. These patients were ambulatory by 7.06 ± 0.91 h after surgery and remained in the hospital for 4.94 ± 0.80 days. Based on these data, operation time and fluoroscopy time were significantly less (P < 0.002 and P < 0.001, respectively) for subjects in the PEID group. However, ambulatory time and hospitalization were similar for both in terms of pain relief and decreased disability, and subjects in both groups responded well to the surgery and showed a significant decrease in both VAS and ODI scores at their 1-year follow-up (P < 0.01). Furthermore, there were no statistically significant differences between the two surgeries in terms of pain relief and decrease in disability.
For L /S disc herniation, PEID and PETD provide similar results for patients. However, PEID has the advantage over PETD in that it is a shorter procedure and exposes the patient to less radiation.
本研究旨在比较经皮内镜下椎间孔入路椎间盘切除术（PEID）和经皮内镜下经椎间孔入路椎间盘切除术（PETD）治疗 L/S 椎间盘突出症的临床疗效。
对 76 例 L/S 椎间盘突出症患者进行回顾性分析。有两组手术治疗：一组患者接受 PEID 治疗，另一组患者接受 PETD 治疗。通过手术时间、术中 X 射线暴露次数、术后卧床时间、住院时间、手术并发症、患者术后使用视觉模拟评分（VAS）评估疼痛、Oswestry 功能障碍指数（ODI）评估残疾等方面对两组进行比较。
PEID 组患者的手术时间为 60.90±13.11 分钟，术中 X 射线暴露次数为 4.10±1.09 次。术后 7.52±1.08 小时患者即可下床活动，住院时间为 5.05±0.92 天。相比之下，PETD 组患者的手术时间为 84.06±15.58 分钟，术中 X 射线暴露次数为 12.81±8.46 次。术后 7.06±0.91 小时患者即可下床活动，住院时间为 4.94±0.80 天。基于这些数据，PEID 组的手术时间和透视时间明显更短（P<0.002 和 P<0.001）。然而，在缓解疼痛和降低残疾程度方面，两组患者的活动时间和住院时间相似，两组患者在术后 1 年随访时均对手术反应良好，VAS 和 ODI 评分均显著降低（P<0.01）。此外，两种手术在缓解疼痛和降低残疾程度方面没有统计学上的显著差异。
对于 L/S 椎间盘突出症，PEID 和 PETD 为患者提供了相似的结果。然而，PEID 比 PETD 具有优势，因为它的手术过程更短，患者暴露于射线的时间更少。
