经皮内镜下经椎间孔椎间盘切除术治疗不同移位程度腰椎间盘突出症的回顾性研究
Percutaneous Endoscopic Transforaminal Discectomy for the Treatment of Lumbar Disc Herniation with Different Migration Levels: A Retrospective Study.
作者信息
Sun Jiewei, Yu Xiaojun, Feng Kan, Zheng Wujun, Lu Yong, Bao Bin
机构信息
Department of Cardiothoracic Surgery, Fuyang First People's Hospital, Hangzhou, Zhejiang Province, People's Republic of China.
出版信息
J Pain Res. 2024 Jan 26;17:367-375. doi: 10.2147/JPR.S437968. eCollection 2024.
OBJECTIVE
To investigate the surgical method and efficacy of percutaneous endoscopic transforaminal discectomy (PETD) for the treatment of lumbar disc herniation (LDH) with different migration levels by introducing the strategy of foramenoplasty with the "distal nucleus pulposus as the core".
METHODS
Clinical data of LDH patients who underwent single-segment PETD surgery were retrospectively analyzed. Three groups were categorized according to the degree of nucleus pulposus migration in the sagittal position: no migration group, mild migration group, and high migration group. Different sites of foramenoplasty were used for LDH with different degrees of migration. All patients were followed up for at least 12 months. The clinical and follow-up data of the three groups were compared.
RESULTS
A total of 102 patients were included, of which 46 (45.1%) were in the no migration group, 36 (35.3%) in the mild migration group, and 20 (19.6%) in the high migration group. Encouraging treatment results were obtained in all three groups.
CONCLUSION
PETD is effective in the treatment of LDH with different degrees of migration, and the foramenoplasty concept of "distal nucleus pulposus as the core" can effectively guide the molding site of foramenoplasty and facilitate the accurate placement of the working trocar.
目的
通过引入以“远侧髓核为核心”的椎间孔成形策略,探讨经皮内镜下经椎间孔椎间盘切除术(PETD)治疗不同移位程度腰椎间盘突出症(LDH)的手术方法及疗效。
方法
回顾性分析接受单节段PETD手术的LDH患者的临床资料。根据髓核矢状位移位程度分为三组:无移位组、轻度移位组和高度移位组。对不同移位程度的LDH采用不同部位的椎间孔成形术。所有患者均随访至少12个月。比较三组的临床及随访资料。
结果
共纳入102例患者,其中无移位组46例(45.1%),轻度移位组36例(35.3%),高度移位组20例(19.6%)。三组均取得了令人满意的治疗效果。
结论
PETD治疗不同移位程度的LDH有效,以“远侧髓核为核心”的椎间孔成形理念能有效指导椎间孔成形的塑形部位,便于工作套管的精准置入。