经皮椎间孔内窥镜椎间盘切除术治疗腰椎间盘突出症：年轻（年龄<60 岁）与老年（年龄≥60 岁）患者。

Percutaneous Transforaminal Endoscopic Diskectomy for Lumbar Disk Herniation: Young (Age <60 years) versus Older (Age ≥60 years) Patients.

机构信息

Department of Orthopedics, Shanghai Fengxian Central Hospital, Shanghai, People's Republic of China.

Department of Orthopedics, Shanghai Sixth Peoples Hospital, Shanghai, Shanghai, People's Republic of China.

出版信息

J Neurol Surg A Cent Eur Neurosurg. 2023 Mar;84(2):103-108. doi: 10.1055/s-0041-1735861. Epub 2021 Dec 12.

DOI:10.1055/s-0041-1735861

PMID:34897623

Abstract

BACKGROUND

We compare the differences in the efficacy of percutaneous transforaminal endoscopic diskectomy (PTED) between the younger (age <60 years) and older (age ≥60 years) patients with lumbar disk herniation (LDH).

METHODS

From December 2016 to December 2017, 128 patients with symptomatic LDH underwent PTED and were followed up. Forty-four 60 years old and above, including 19 males and 25 females with an average age of 68.7 (61-82) years, were classified as the elderly age group. Eighty-four patients younger than 60 years were classified as the young age group, which included 48 males and 36 females with an average age of 44.7 (16-58) years. The visual analog scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, and satisfaction rates of the two groups before and after surgery were compared.

RESULTS

The operation was completed successfully in both groups. The average follow-up times of the elderly and young age groups were 18.47 ± 2.62 (12-23) and 17.90 ± 3.27 (12-23) months, respectively. One patient in the young age group had recurrence 7 months after surgery, and the symptoms were relieved after PTED was performed again. Two patients with nerve root injury after surgery in the young age group completely recovered after 2 months of conservative treatment. There were no significant surgical complications in the elderly age group. There was no significant difference in postoperative VAS, JOA, and MacNab scores between the two groups. The MacNab scores in the elderly age group were excellent for 28 patients, good for 10 patients, and fair for 6 patients; the satisfaction rate was 86.3%. In the young age group, scores were excellent for 63 patients, good for 14 patients, fair for 5 patients, and poor for 2 patients; the satisfaction rate was 91.7%.

CONCLUSION

The clinical effectiveness of PTED for treatment of LDH in both elderly and young patients is satisfactory. Age is not a predictor of poor outcomes of PTED.

摘要

背景

我们比较了年轻（<60 岁）和老年（≥60 岁）腰椎间盘突出症（LDH）患者经皮经椎间孔内窥镜椎间盘切除术（PTED）疗效的差异。

方法

2016 年 12 月至 2017 年 12 月，128 例症状性 LDH 患者接受了 PTED 治疗并进行了随访。44 例年龄在 60 岁以上，包括 19 例男性和 25 例女性，平均年龄为 68.7（61-82）岁，分为老年组。84 例年龄小于 60 岁的患者分为年轻组，包括 48 例男性和 36 例女性，平均年龄为 44.7（16-58）岁。比较两组患者术前和术后视觉模拟评分（VAS）、日本骨科协会（JOA）评分和满意度。

结果

两组手术均顺利完成。老年组和年轻组的平均随访时间分别为 18.47±2.62（12-23）和 17.90±3.27（12-23）个月。年轻组 1 例患者术后 7 个月复发，再次行 PTED 后症状缓解。年轻组 2 例术后神经根损伤患者经 2 个月保守治疗后完全恢复。老年组无严重手术并发症。两组术后 VAS、JOA 和 MacNab 评分无显著差异。老年组 MacNab 评分优 28 例，良 10 例，可 6 例；满意度为 86.3%。年轻组优 63 例，良 14 例，可 5 例，差 2 例；满意度为 91.7%。