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经皮椎间孔镜下椎间盘切除术是治疗腰椎间盘突出症的一种更安全的方法。

Percutaneous transforaminal endoscopic discectomy is a safer approach for lumbar disc herniation.

作者信息

Ge Rile, Liu Zhongdi, Huang Wei

机构信息

Trauma Medicine Center, Peking University People's Hospital Xicheng District, Beijing 100044, China.

National Center for Trauma Medicine Xicheng District, Beijing 100044, China.

出版信息

Am J Transl Res. 2022 Sep 15;14(9):6359-6367. eCollection 2022.

Abstract

OBJECTIVES

Herein, we explored the safety and efficacy of the percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) in the treatment of lumbar disc herniation (LDH).

METHODS

The complete clinical data of 87 LDH patients, who were admitted to the Peking University People's Hospital between May 2018 and March 2020, were retrospectively analyzed. These patients were initially separated into a control (n=39, treated with FD) and research group (n=48, treated with PTED), based on the prescribed treatments. We compared the basic operational conditions between the two groups, and assessed the surgical outcomes using the visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association Scores (JOA), and modified MacNab scale. Lastly, we analyzed the complication incidence and life quality of patients at 1-year follow up after surgery.

RESULTS

All participants in both groups completed the operation. The amount of intraoperative blood loss, surgical duration, length of surgical incision, postoperative ambulation start time, and length of hospital stay were all significantly shorter in the research group as compared to the control group (P<0.05). Moreover, the VAS and ODI scores of the patients in the research group were lower than the control group at 3-months after surgery, while the JOA score was markedly higher (all P<0.05). In addition, the success rate was higher, and the complication rate lower, in the research group, compared to the control group (all P<0.05). Lastly, no statistical differences were observed in the quality of life of patients before the operation, or at 1-year follow up (P>0.05).

CONCLUSIONS

Based on our analyses, PTED and FD were both effective in treating LDH. However, PTED exhibited a higher success rate, faster recovery time, and was safer than FD.

摘要

目的

在此,我们探讨了经皮椎间孔镜下椎间盘切除术(PTED)和开窗椎间盘切除术(FD)治疗腰椎间盘突出症(LDH)的安全性和有效性。

方法

回顾性分析2018年5月至2020年3月在北京大学人民医院住院的87例LDH患者的完整临床资料。根据规定的治疗方法,这些患者最初被分为对照组(n = 39,接受FD治疗)和研究组(n = 48,接受PTED治疗)。我们比较了两组之间的基本手术情况,并使用视觉模拟量表(VAS)、Oswestry功能障碍指数(ODI)、日本骨科协会评分(JOA)和改良MacNab量表评估手术结果。最后,我们分析了患者术后1年随访时的并发症发生率和生活质量。

结果

两组所有参与者均完成手术。与对照组相比,研究组术中出血量、手术时间、手术切口长度、术后下床活动开始时间和住院时间均显著缩短(P < 0.05)。此外,研究组患者术后3个月的VAS和ODI评分低于对照组,而JOA评分明显更高(均P < 0.05)。此外,与对照组相比,研究组的成功率更高,并发症发生率更低(均P < 0.05)。最后,术前或术后1年随访时患者的生活质量未观察到统计学差异(P > 0.05)。

结论

根据我们的分析,PTED和FD在治疗LDH方面均有效。然而,PTED显示出更高的成功率、更快的恢复时间,并且比FD更安全。

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