胶原酶化学溶解术对经椎间孔腰椎内镜下椎间盘切除术后残留疼痛的影响。
Effect of Collagenase Chemonucleolysis on Residual Pain After Transforaminal Lumbar Endoscopic Discectomy.
作者信息
Han Liuhu, Li Tingting, Chen Liyang, Guo Yuyu, Zhao Long, Hu Jun, Wang Likui
机构信息
AnHui Medical University, HeFei, People's Republic of China.
Department of Pain, The First Affiliate Hospital of AnHui Medical University, Hefei, People's Republic of China.
出版信息
J Pain Res. 2023 Apr 14;16:1257-1265. doi: 10.2147/JPR.S402534. eCollection 2023.
PURPOSE
To investigate the short-term clinical effect of collagenase chemonucleolysis (CCNL) in the treatment of residual pain after transforaminal lumbar endoscopic discectomy (TLED).
PATIENTS AND METHODS
The clinical data of 40 patients with residual pain after TLED for lumbar disc herniation (LDH) in our hospital from January 2018 to December 2020 were retrospectively analyzed. The visual analogue scale (VAS) and quality of recovery-15 (QoR-15) were used to evaluate the effect of the operation. Modified MacNab method was used to evaluate the efficacy of CCNL at 6 months and 12 months after operation.
RESULTS
All patients successfully completed the operation without serious complications, such as intervertebral space infection, vascular injury and nerve injury. The VAS 3 days after TLED was not significantly lower than that Pre-TLED (P > 0.05). The VAS at each time point after CCNL was significantly lower than that at Pre-TLED, and the QoR-15 score at each time point after CCNL was significantly higher than that 3 days after CCNL (P < 0.05). The modified MacNab criteria for the last follow-up was 95%.
CONCLUSION
CCNL can effectively relieve the residual pain after TLED, and the quality of life of patients after TLED is improved with time, and the safety of CCNL is higher.
目的
探讨胶原酶化学溶解术(CCNL)治疗经椎间孔腰椎内镜下椎间盘切除术(TLED)后残留疼痛的短期临床效果。
患者与方法
回顾性分析2018年1月至2020年12月我院40例因腰椎间盘突出症(LDH)行TLED术后残留疼痛患者的临床资料。采用视觉模拟评分法(VAS)和康复质量-15(QoR-15)评估手术效果。采用改良MacNab法在术后6个月和12个月评估CCNL的疗效。
结果
所有患者均成功完成手术,未发生椎间间隙感染、血管损伤和神经损伤等严重并发症。TLED术后3天的VAS评分与术前相比差异无统计学意义(P>0.05)。CCNL术后各时间点的VAS评分均显著低于术前,且CCNL术后各时间点的QoR-15评分均显著高于CCNL术后3天(P<0.05)。末次随访时改良MacNab标准评定优良率为95%。
结论
CCNL能有效缓解TLED术后残留疼痛,TLED术后患者生活质量随时间改善,且CCNL安全性较高。