Zhang Guoqiang, Xie Xuehu, Liu Ning
Capital Medical University, Beijing Friendship Hospital, Department of Orthopedics, Beijing, China.
Acta Ortop Bras. 2023 Oct 23;31(5):e263326. doi: 10.1590/1413-785220233105e263326. eCollection 2023.
A previous study has reported the therapeutic effects of interlaminar/transforaminal approaches under full-endoscopic visualization to treat L5-S1 lumber disc herniation (LDH). However, the comparison of interlaminar/transforaminal approaches to treat other segments of LDH remains unclear.
To evaluate the clinical efficacy of full-endoscopic interlaminar and transforaminal lumbar discectomy to treat LDH.
A total of 93 patients with LDH who underwent fully-endoscopic lumbar interlaminar/transforaminal discectomy were retrospectively collected. Patients were divided into a Transforaminal group (n=41) and an Interlaminar group (n=52). Clinical efficacy was evaluated by visual analogue scale (VAS), the Oswestry disability index (ODI), and the modified MacNab scoring system.
Of the 93 patients, involving segments in LDH referred to L, L, and L. The fluoroscopy times in the Interlaminar group were smaller than that of the Transforaminal group. We found no obvious significances between the Transforaminal and Interlaminar groups regarding operation time, incision length, postoperative landing time, hospitalization, and incision healing time. Postoperative VAS and ODI scores notably improved at follow-up. Besides, almost 90% LDH patients achieved excellent/good outcomes.
The full-endoscopic visualization technique via interlaminar and transforaminal approaches safely and effectively treat LDH.
先前的一项研究报告了在全内镜可视化下采用椎间孔/经椎间孔入路治疗L5-S1腰椎间盘突出症(LDH)的治疗效果。然而,椎间孔/经椎间孔入路治疗其他节段LDH的比较仍不明确。
评估全内镜下椎间孔和经椎间孔腰椎间盘切除术治疗LDH的临床疗效。
回顾性收集93例行全内镜下腰椎椎间孔/经椎间孔椎间盘切除术的LDH患者。患者分为经椎间孔组(n = 41)和椎间孔组(n = 52)。采用视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)和改良MacNab评分系统评估临床疗效。
93例患者中,LDH涉及的节段为L、L和L。椎间孔组的透视时间短于经椎间孔组。我们发现经椎间孔组和椎间孔组在手术时间、切口长度、术后下地时间、住院时间和切口愈合时间方面没有明显差异。随访时术后VAS和ODI评分显著改善。此外,近90%的LDH患者获得了优/良的治疗效果。
通过椎间孔和经椎间孔入路的全内镜可视化技术安全有效地治疗LDH。