Cheng Yuanpei, Zhang Qianru, Li Yongbo, Chen Xipeng, Wu Han
Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China.
Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Front Surg. 2022 Sep 23;9:998231. doi: 10.3389/fsurg.2022.998231. eCollection 2022.
Calcified lumbar disc herniation (CLDH) is considered to be a special type of lumbar disc herniation (LDH). Percutaneous endoscopic interlaminar discectomy (PEID), with safety and efficacy, has been proved to be a minimally invasive surgery for LDH. However, there are few studies on PEID in the treatment of CLDH at the L5-S1 level. This study aimed to analyze the clinical efficacy of PEID for L5-S1 CLDH.
From August 2016 to April 2020, we retrospectively analyzed 28 consecutive patients (17 males and 11 females) with L5-S1 CLDH treated with PEID at our institution. All the patients were monitored for more than 1 year postoperatively. The demographic characteristics, surgical results, and clinical outcomes estimated by the visual analog scale (VAS) for leg pain, the Oswestry disability index (ODI), and the modified MacNab criteria were collected.
All patients successfully underwent PEID. The mean operative time and intraoperative blood loss were 65.36 ± 5.26 min and 13.21 ± 4.35 ml, respectively. The VAS for leg pain and ODI scores improved remarkably from 7.54 ± 0.96 to 1.50 ± 0.51 ( < 0.05) and from 69.29 ± 9.91 to 17.43 ± 3.69 ( < 0.05) a year after operation, respectively. According to the modified MacNab criteria of the last follow-up, the excellent and good rates are 92.86%. Two of the patients had complications, one had nerve root injury and the other had postoperative dysesthesia.
PEID achieved good clinical outcomes in the treatment of L5-S1 CLDH, and it was a safe and effective minimally invasive surgery for L5-S1 CLDH.
钙化型腰椎间盘突出症(CLDH)被认为是腰椎间盘突出症(LDH)的一种特殊类型。经皮内镜椎间孔切开椎间盘切除术(PEID)具有安全性和有效性,已被证明是治疗LDH的一种微创手术。然而,关于PEID治疗L5-S1水平CLDH的研究较少。本研究旨在分析PEID治疗L5-S1 CLDH的临床疗效。
2016年8月至2020年4月,我们回顾性分析了在我院接受PEID治疗的28例连续L5-S1 CLDH患者(男17例,女11例)。所有患者术后均接受了超过1年的随访。收集患者的人口统计学特征、手术结果以及通过视觉模拟量表(VAS)评估的腿痛、Oswestry功能障碍指数(ODI)和改良MacNab标准的临床结局。
所有患者均成功接受了PEID。平均手术时间和术中出血量分别为65.36±5.26分钟和13.21±4.35毫升。术后1年,腿痛VAS评分和ODI评分分别从7.54±0.96显著改善至1.50±0.51(P<0.05)和从69.29±9.91显著改善至17.43±3.69(P<0.05)。根据最后一次随访的改良MacNab标准,优良率为92.86%。2例患者出现并发症,1例发生神经根损伤,另1例出现术后感觉异常。
PEID治疗L5-S1 CLDH取得了良好的临床效果,是治疗L5-S1 CLDH安全有效的微创手术。