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经侧方上关节突入路全内镜下腰椎间盘切除术治疗极外侧型腰椎间盘突出症:回顾性研究和技术说明。

Full-endoscopic lumbar discectomy via lateral superior articular process approach for treating far lateral lumbar disc herniation: a retrospective study and technical note.

机构信息

Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Yuzhong District, Chongqing, 400010, China.

Pain Medical Center, The Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Yuzhong District, Chongqing, 400010, China.

出版信息

Int Orthop. 2023 Nov;47(11):2843-2850. doi: 10.1007/s00264-023-05937-0. Epub 2023 Aug 26.

Abstract

PURPOSE

This study aims to evaluate the efficacy and safety of the full-endoscopic lumbar discectomy (FELD) via lateral superior articular process (LSAP) approach and full-endoscopic transforaminal discectomy (FETD) for treating far lateral lumbar disk herniation (FFLDH).

METHODS

From January 2020 to June 2022, patients who were diagnosed as FLLDH underwent the FELD via LSAP approach or FETD. The operation time, estimated blood loss, length of hospital stays, and complications were recorded. The visual analog scale (VAS) for back pain, VAS for leg pain, and the Oswestry Disability Index (ODI) scores was measured during preoperative and postoperative follow-up.

RESULTS

Thirty-two patients were enrolled in this study, of which 12 patients were treated with the FELD via LSAP approach (LSAP-FELD group) and 20 patients underwent FETD (FETD group). The LSAP-FELD group exhibited significantly shorter operation times and hospital stays compared to the FETD group, while no statistically significant differences were observed in intraoperative blood loss and complication rates. There were no significant differences in the VAS for back pain, the VAS for leg pain, and the ODI score between the two groups preoperatively and three days, three months, and the last follow-up postoperatively.

CONCLUSIONS

Both the FELD via LSAP approach and FETD have demonstrated favourable clinical efficacy in the treatment of FLLDH. Notably, the FELD via LSAP approach shows the advantages of shorter operation time and hospital stays.

摘要

目的

本研究旨在评估经侧方上关节突(LSAP)入路全内镜下腰椎间盘切除术(FELD)与全内镜经椎间孔腰椎间盘切除术(FETD)治疗极外侧型腰椎间盘突出症(FFLDH)的疗效和安全性。

方法

2020 年 1 月至 2022 年 6 月,对诊断为 FLLDH 的患者行 FELD 经 LSAP 入路或 FETD 治疗。记录手术时间、估计失血量、住院时间和并发症。术前及术后随访时测量视觉模拟评分(VAS)腰痛、VAS 腿痛和 Oswestry 功能障碍指数(ODI)评分。

结果

本研究共纳入 32 例患者,其中 12 例患者接受 FELD 经 LSAP 入路治疗(LSAP-FELD 组),20 例患者接受 FETD 治疗(FETD 组)。LSAP-FELD 组的手术时间和住院时间明显短于 FETD 组,而术中出血量和并发症发生率无统计学差异。两组患者术前及术后 3 天、3 个月及末次随访时 VAS 腰痛、VAS 腿痛及 ODI 评分无统计学差异。

结论

FELD 经 LSAP 入路和 FETD 治疗 FLLDH 均具有良好的临床疗效。值得注意的是,FELD 经 LSAP 入路具有手术时间和住院时间短的优势。

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