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两种常用微创脊柱手术在治疗腰椎间盘突出症中的应用价值比较。

Comparison of the application value of two commonly used minimally invasive spinal surgery in the treatment of lumbar disc herniation.

作者信息

Zhang Yingbo, Chen Jinping, Xie Haiyang, Li Kui, Wang Ye, Chen Qian, Jiang Cheng, He Jiangtao, Fu Nenggao

机构信息

Department of Orthopaedics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China.

出版信息

Exp Ther Med. 2021 Apr;21(4):299. doi: 10.3892/etm.2021.9730. Epub 2021 Jan 28.

Abstract

The aim of the study was to compare the application value of percutaneous transforaminal endoscopic discectomy (PTED) and microendoscopic discectomy (MED) in the treatment of lumbar disc herniation (LDH). From January 2017 to July 2018, 108 LDH patients undergoing surgical treatment in our hospital were collected and divided into PTED group (treated with PTED, n=50) and MED group (treated with MED, n=58). The operation parameter index level, complications, recurrence and pain score (VAS), Oswestry disability index (ODI) and Japanese Orthopaedic Association Scale (JOA) were compared between the two groups. VAS, ODI and JOA scores of the two groups were significantly decreased after operation (P<0.05), but there was no significant difference between the two groups (P>0.05). Complications and recurrence of the two groups were similar (P>0.05). MED was superior to PTED in the number of intraoperative fluoroscopy and operation time, while PTED was superior to MED in intraoperative blood loss, incision length, length of hospital stay and bed rest time (P<0.05). Both PTED and MED can effectively treat LDH. Referring to clinical data, PTED may be the first choice for LDH treatment.

摘要

本研究的目的是比较经皮椎间孔镜下椎间盘切除术(PTED)和显微内镜下椎间盘切除术(MED)在治疗腰椎间盘突出症(LDH)中的应用价值。收集2017年1月至2018年7月在我院接受手术治疗的108例LDH患者,分为PTED组(采用PTED治疗,n = 50)和MED组(采用MED治疗,n = 58)。比较两组的手术参数指标水平、并发症、复发情况以及疼痛评分(VAS)、Oswestry功能障碍指数(ODI)和日本骨科协会评分(JOA)。两组患者术后VAS、ODI和JOA评分均显著降低(P < 0.05),但两组间差异无统计学意义(P > 0.05)。两组的并发症和复发情况相似(P > 0.05)。MED在术中透视次数和手术时间方面优于PTED,而PTED在术中出血量、切口长度、住院时间和卧床休息时间方面优于MED(P < 0.05)。PTED和MED均可有效治疗LDH。参考临床资料,PTED可能是LDH治疗的首选。

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