Wang Hao, Zhou Tianyao, Gu Yutong, Yan Zuoqin
Department of Orthopaedic Surgery, Zhongshan Hospital Fudan University, 200032, Shanghai, China.
Shanghai Medical College, Fudan University, 200032, Shanghai, China.
BMC Musculoskelet Disord. 2021 Jan 12;22(1):65. doi: 10.1186/s12891-020-03938-3.
Percutaneous transforaminal endoscopy has been widely used to treat lumbar disc herniation (LDH), but the steep learning curve and difficulties in removing the calcified disc hinders the application of conventional endoscopy in treating calcified lumbar disc herniation (CLDH). In 2017, we first reported Percutaneous Transforaminal Endoscopic Surgery (PTES) as an easy-to-learn posterolateral transforaminal endoscopic technique to decompress the nerve root for LDH. We used our PTES technique to remove the calcified LDH and the purpose of this study is to evaluate the safety and efficacy of this technique.
Forty-six patients with CLDH and fifty-five patients with uncalcified lumbar disc herniation (ULDH) underwent PTES to decompress the nerve root. Visual analogue scale was collected before the surgery, immediately, one week, one month, two months, three months, six months, 12 months and 24 months after surgery. The outcomes of MacNab classification were collected 24 months after surgery. Intra- and Post-operative complications were also recorded.
For CLDH patients, the VAS score was 9 (5-10) before operation, and then dropped to 2 (1-4) after surgery. VAS score continually decreased to 0 (0-3) at 24 months after surgery. 95.65% of CLDH patients showed excellent or good outcomes. ULDH group showed similar MacNab classification (94.55%) and VAS changing curve. The therapeutic effect of PTES in treating CLDH was as good as that in treating uncalcified patients.
PTES is an effective and safe method to treat calcified lumbar disc herniation.
经皮椎间孔镜技术已广泛应用于治疗腰椎间盘突出症（LDH），但传统椎间孔镜技术陡峭的学习曲线以及钙化椎间盘的切除困难阻碍了其在治疗钙化腰椎间盘突出症（CLDH）中的应用。2017年，我们首次报道了经皮椎间孔镜手术（PTES），这是一种易于学习的后外侧椎间孔镜技术，用于减压LDH的神经根。我们使用PTES技术切除钙化的LDH，本研究的目的是评估该技术的安全性和有效性。
46例CLDH患者和55例非钙化腰椎间盘突出症（ULDH）患者接受PTES以减压神经根。在手术前、术后即刻、1周、1个月、2个月、3个月、6个月、12个月和24个月收集视觉模拟量表评分。在术后24个月收集MacNab分类结果。还记录了术中及术后并发症。
对于CLDH患者，术前VAS评分为9（5-10），术后降至2（1-4）。术后24个月VAS评分持续降至0（0-3）。95.65%的CLDH患者显示出优秀或良好的结果。ULDH组显示出相似的MacNab分类（94.55%）和VAS变化曲线。PTES治疗CLDH的疗效与治疗非钙化患者的疗效一样好。
PTES是治疗钙化腰椎间盘突出症的一种有效且安全的方法。
