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经椎间孔内镜下椎间孔切开术和椎间盘切除术治疗软性和钙化性胸椎间盘突出症的五年疗效

Five-Year Outcomes After Transforaminal Endoscopic Foraminotomy and Discectomy for Soft and Calcified Thoracic Disc Herniations.

作者信息

Houra Karlo, Saftic Robert, Knight Martin

机构信息

Aksis-Specialty Hospital for Spine and Orthopaedic Surgery, Petrovaradinska 1 Street, 10000 Zagreb, Croatia.

University North, University Center Varazdin, Jurja Krizanica Street 31b, 42000 Varazdin, Croatia.

出版信息

Int J Spine Surg. 2021 Jun;15(3):494-503. doi: 10.14444/8071. Epub 2021 May 7.

Abstract

BACKGROUND

The aim of this study was to evaluate the safety and long-term clinical outcomes of transforaminal full endoscopic discectomy and foraminotomy performed with manual reamers under local anesthesia on soft and calcified herniated discs in the mid and lower thoracic spine.

METHODS

Postoperative pain relief was self-evaluated by 16 patients using a visual analog scale (VAS) and Oswestry Disability Index (ODI). Patients were scored at 6, 12, 24, and 60 months after surgery.

RESULTS

Significant pain reduction of more than 50% in the VAS score was achieved in 15 out of 16 patients at all review points throughout this study. Similarly, a decrease of more than 50% in ODI scores was achieved in 15 out of 16 patients in all 4 review points. There were no surgical complications. Good postoperative results were achieved in patients regardless of the consistency of the disc herniation.

CONCLUSIONS

Transforaminal full endoscopic discectomy and foraminotomy with manual reamers performed under local anesthesia produces sustained reduction in pain and improves functionality in patients with mid and lower thoracic spine soft and calcified disc herniations. The surgery is safe and straightforward to perform with the correct training.

LEVEL OF EVIDENCE

CLINICAL RELEVANCE

Thoracic transforaminal endoscopic discectomy and foraminotomy, performed in TIVA, may be a useful adjunct for treatment of patients with soft and calcified disc herniations in thoracic spine.

摘要

背景

本研究的目的是评估在局部麻醉下使用手动扩孔钻进行经椎间孔全内镜椎间盘切除术和椎间孔切开术治疗胸段中下部软性和钙化性椎间盘突出症的安全性和长期临床疗效。

方法

16例患者术后采用视觉模拟评分法(VAS)和Oswestry功能障碍指数(ODI)进行自我疼痛缓解评估。在术后6、12、24和60个月对患者进行评分。

结果

在本研究的所有复查点,16例患者中有15例VAS评分显著降低超过50%。同样,在所有4个复查点,16例患者中有15例ODI评分降低超过50%。无手术并发症。无论椎间盘突出的质地如何,患者均取得了良好的术后效果。

结论

在局部麻醉下使用手动扩孔钻进行经椎间孔全内镜椎间盘切除术和椎间孔切开术可使胸段中下部软性和钙化性椎间盘突出症患者的疼痛持续减轻,并改善其功能。经过正确培训,该手术操作安全且简便。

证据级别

4级。

临床意义

在全凭静脉麻醉下进行的胸段经椎间孔内镜椎间盘切除术和椎间孔切开术,可能是治疗胸段软性和钙化性椎间盘突出症患者的一种有用辅助方法。

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Surgical treatment of thoracic disc herniation: an overview.胸椎间盘突出症的手术治疗:概述。
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