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经椎间孔内镜技术治疗上腰椎间盘突出症

Treatment of Upper Lumbar Disc Herniation with a Transforaminal Endoscopic Technique.

作者信息

Wang Zuowei, Jian Fengzeng, Wu Hao, Wang Xingwen, Wang Kai, Duan Wanru, Liu Zhenlei, Chen Zan

机构信息

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China.

出版信息

Front Surg. 2022 Apr 28;9:893122. doi: 10.3389/fsurg.2022.893122. eCollection 2022.

Abstract

BACKGROUND

To investigate the clinical efficacy of percutaneous endoscopic transforaminal discectomy (PETD) in the treatment of upper lumbar disc herniation (LDH).

METHODS

Twenty-two patients, 14 males and 8 females with ages ranging from 23 to 76 years, who had upper LDH and were treated with PETD from April 2015 to April 2020 in the Department of Neurosurgery of Xuanwu Hospital, were selected to evaluate the surgical efficacy by the visual analog scale (VAS) and Oswestry Disability Index (ODI).

RESULTS

All patients underwent successful completion of PETD surgery. The operation time was 80.4 ± 18.0 min; intraoperative fluoroscopy was used 17.1 ± 8.7 times; and the hospital stay was 3.2 ± 0.6 days. The VAS scores were 7.9 ± 1.2, 2.3 ± 1.5, 2.2 ± 1.3, and 2.1 ± 1.0 before the operation, 1 day and 3 months after the operation, and during the last follow-up, respectively. The postoperative VAS score was significantly lower than that before the operation ( < 0.01). The ODI scores before and 3 months after the operation were 59.8 ± 16.8 and 15.3 ± 8.2, respectively; thus, the postoperative score was decreased ( < 0.01).

CONCLUSION

Upper lumbar discs have unique anatomical structures, and PETD is a safe and effective surgical method for the treatment of upper LDH.

摘要

背景

探讨经皮内镜下椎间孔入路椎间盘切除术(PETD)治疗上腰椎间盘突出症(LDH)的临床疗效。

方法

选取2015年4月至2020年4月在宣武医院神经外科接受PETD治疗的22例上腰椎间盘突出症患者,其中男性14例,女性8例,年龄23至76岁,采用视觉模拟评分法(VAS)和Oswestry功能障碍指数(ODI)评估手术疗效。

结果

所有患者PETD手术均顺利完成。手术时间为80.4±18.0分钟;术中透视17.1±8.7次;住院时间为3.2±0.6天。术前、术后1天、术后3个月及末次随访时的VAS评分分别为7.9±1.2、2.3±1.5、2.2±1.3和2.1±1.0。术后VAS评分显著低于术前(<0.01)。术前及术后3个月的ODI评分分别为59.8±16.8和15.3±8.2,术后评分降低(<0.01)。

结论

上腰椎具有独特的解剖结构,PETD是治疗上腰椎间盘突出症安全有效的手术方法。

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