经皮穿刺腰椎间盘切吸术治疗包容性腰椎间盘突出症的临床疗效:一项回顾性研究。
Clinical efficacy of nucleoplasty for uncontained lumbar disc herniation: a retrospective study.
机构信息
Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
出版信息
BMC Musculoskelet Disord. 2024 Jan 2;25(1):12. doi: 10.1186/s12891-023-07120-3.
BACKGROUND
There are insufficient in-depth studies on whether percutaneous lumbar nucleoplasty (PLN) is effective and safe for the treatment of uncontained lumbar disc herniation (ULDH). This study aimed to investigate the clinical efficacy of PLN on radiating leg pain caused by ULDH.
METHODS
Patients who underwent PLN for ULDH and met the inclusion criteria between June 2018 and July 2022 were included. Clinical outcomes were evaluated using the numeric rating scale (NRS) for radiating pain preoperatively; at 1 day, 1 week, and 1 month postoperatively; and at the last follow-up. Patient satisfaction was assessed using MacNab criteria.
RESULTS
Forty-one patients were enrolled. The mean age was 50.2 years (range 24-73 years). The mean and standard deviation of the preoperative NRS in 39 patients with radiating pain was 9.0 ± 1.2. The NRS scores at 1 day, 1 week, and 1 month postoperatively and at the last follow-up were 4.6 ± 3.2, 3.6 ± 3.3, 2.9 ± 3.2, and 1.4 ± 2.0, respectively, showing significant improvement (all, p < 0.001). The number of patients (percentage) with excellent or good satisfaction according to the MacNab criteria was 29 (70.7%). Major complications were not observed. Three patients underwent additional surgery after PLN because of persistent radiating pain.
CONCLUSIONS
PLN is a safe and feasible treatment option for ULDH. Treatment outcomes were favorable on average; however, the lack of consistency was a drawback.
背景
对于未包裹型腰椎间盘突出症(ULDH),经皮腰椎间盘髓核成形术(PLN)的疗效和安全性的深入研究还不够充分。本研究旨在探讨 PLN 治疗 ULDH 放射状腿痛的临床疗效。
方法
纳入 2018 年 6 月至 2022 年 7 月期间因 ULDH 而行 PLN 并符合纳入标准的患者。采用数字评分量表(NRS)评估术前、术后 1 天、1 周、1 个月及末次随访时的放射痛,并采用 MacNab 标准评估患者满意度。
结果
共纳入 41 例患者。平均年龄为 50.2 岁(24-73 岁)。39 例有放射痛患者的术前 NRS 平均(标准差)为 9.0(1.2)。术后 1 天、1 周、1 个月及末次随访时的 NRS 评分分别为 4.6(3.2)、3.6(3.3)、2.9(3.2)和 1.4(2.0),均有显著改善(均,p < 0.001)。根据 MacNab 标准,有 29 例(70.7%)患者满意度为优或良。未观察到主要并发症。3 例患者因放射痛持续而在 PLN 后行额外手术。
结论
PLN 是治疗 ULDH 的一种安全且可行的选择。总体而言,治疗效果良好,但缺乏一致性是一个缺点。