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一期经皮内镜腰椎间盘切除术治疗症状性双节段连续青少年腰椎间盘突出症。

One-Stage Percutaneous Endoscopic Lumbar Discectomy for Symptomatic Double-Level Contiguous Adolescent Lumbar Disc Herniation.

机构信息

Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.

Pain medicine Center, Peking University Third Hospital, Beijing, China.

出版信息

Orthop Surg. 2021 Jul;13(5):1532-1539. doi: 10.1111/os.13097. Epub 2021 Jun 3.

Abstract

OBJECTIVE

To assess the clinical efficacy of one-stage percutaneous endoscopic lumbar discectomy (PELD) for symptomatic double-level contiguous adolescent lumbar disc herniation (ALDH).

METHODS

This retrospective study included 16 patients who presented with back and/or leg pain due to double-level disc herniation underwent PELD for symptomatic lumbar disc herniation (0.27%,16/5877) from January 2014 to September 2019. After follow-up period of 17.3 months in average, numeric rating scale (NRS) scores and modified Macnab criteria were used to assess the preoperative and postoperative clinical results. Quantitative data were expressed as mean standard deviation (SD) and the data for the variation in the NRS scores before and after the operation were compared using the Wilcoxon two-sample test. Analyses were performed with IBM SPSS Statistics for Windows, version 19.0 (IBM, Armonk, NY, USA). Values of P < 0.05 were considered significantly different.

RESULTS

There were 11 male and 5 female patients, with an average age of 19.3 years (range, 15-22 years). One case affected the L - L /L -L level, seven cases affected the L - L /L - L level, and eight cases affected the L - L /L -S level. The NRS scores decreased significantly in both early and late follow-up evaluations and these scores demonstrated significant improvement in late follow-up (P < 0.05). For the modified Macnab criteria, the final outcome results were excellent in 14 patients (87.5%), good in 1 patient (6.25%), fair in 1 patient (6.25%), and the overall success rate was 93.75%.

CONCLUSION

This study's data suggest that one-stage PELD is promising treatment strategy for selected symptomatic double-level contiguous adolescent lumbar disc herniation.

摘要

目的

评估一期经皮内窥镜腰椎间盘切除术(PELD)治疗症状性双节段连续青少年腰椎间盘突出症(ALDH)的临床疗效。

方法

本回顾性研究纳入了 2014 年 1 月至 2019 年 9 月期间因双节段椎间盘突出症而出现腰背部和/或下肢疼痛的 16 例患者,这些患者均接受了 PELD 治疗。平均随访 17.3 个月后,采用数字评分量表(NRS)评分和改良 Macnab 标准评估术前和术后的临床结果。定量数据用平均值标准差(SD)表示,采用 Wilcoxon 两样本检验比较手术前后 NRS 评分的变化。分析采用 IBM SPSS Statistics for Windows,版本 19.0(IBM,Armonk,NY,USA)。P 值小于 0.05 为差异有统计学意义。

结果

16 例患者中,男 11 例,女 5 例,平均年龄 19.3 岁(1522 岁)。1 例病变位于 L₅S₁/L₅S₁ 水平,7 例病变位于 L₅S₁/L₄L₅ 水平,8 例病变位于 L₃S₁/L₃~L₅ 水平。NRS 评分在早期和晚期随访评估中均显著降低,晚期随访时评分显著改善(P<0.05)。根据改良 Macnab 标准,14 例(87.5%)患者的最终疗效结果为优,1 例(6.25%)为良,1 例(6.25%)为可,总体成功率为 93.75%。

结论

本研究数据表明,一期 PELD 是治疗症状性双节段连续青少年腰椎间盘突出症的一种有前景的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9545/8313176/87a8016a04b8/OS-13-1532-g005.jpg

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