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经皮椎间孔镜下椎间盘切除术联合纤维环修复治疗中青年单节段腰椎间盘突出症的临床疗效研究

Study on the clinical effect of percutaneous transforaminal endoscopic discectomy combined with annulus fibrosus repair in the treatment of single-segment lumbar disc herniation in young and middle-aged patients.

作者信息

Zhao Ya-Fei, Tian Bin-Wu, Ma Qiu-Shuang, Zhang Meng

机构信息

Ya-fei Zhao, Department of Orthopedics, Baoding No.1 Hospital of Traditional Chinese Medicine, Baoding 071000, Hebei, P.R. China.

Bin-wu Tian, Department of Orthopedics, Baoding No.1 Hospital of Traditional Chinese Medicine, Baoding 071000, Hebei, P.R. China.

出版信息

Pak J Med Sci. 2024 Jan-Feb;40(3Part-II):427-432. doi: 10.12669/pjms.40.3.3419.

Abstract

OBJECTIVE

To explore the clinical effect of percutaneous transforaminal endoscopic discectomy (PTED) combined with annulus fibrosus repair in the treatment of single-segment lumber disc herniation (LDH) in young and middle-aged patients.

METHODS

Ninty-six patients with single-segment LDH admitted to Baoding First Central Hospital from March 2021 to November 2022 were selected in the retrospective study. The patients were divided into endoscopic group and combined group according to different surgical methods. The surgical conditions, VAS score and ODI score the two groups of patients were compared, as well as the postoperative review results.

RESULTS

There were 50 patients in the endoscopic group the average operation time was 43.68 ± 10.77 minutes, the average intraoperative blood loss was 35.38 ± 10.02 ml, there were seven cases of surgical segment recurrence and 10 cases of postoperative intervertebral instability at the surgical segment. There were 46 patients in the combined group, the average operation time was 52.26 ± 8.39 minutes, the average intraoperative blood loss was 39.23 ± 9.02ml, there was one case of surgical segment recurrence and two cases of surgical segment intervertebral instability. The operation time (t=-4.328, P<0.01), postoperative recurrence cases (χ=4.386, P<0.05) and intervertebral instability cases (χ=5.366, P<0.05) of the two groups of patients). The difference was statistically significant. There was no significant difference in intraoperative blood loss between the two groups (t=-1.965, P>0.05). For six months after surgery, the differences in VAS and ODI scores between the two groups were statistically significant. In addition, there were statistically significant differences in the VAS scores and ODI scores of the two groups of patients at each time point after surgery compared with those before surgery (P<0.05).

CONCLUSION

The clinical efficacy of PTED combined with annulus fibrosus repair showed better clinical efficacy than PTED alone, and it can reduce the occurrence of surgical segment recurrence and intervertebral instability, suggesting that PTED combined with annulus fibrosus repair may be worthy of promotion in clinical practice.

摘要

目的

探讨经皮椎间孔镜下椎间盘切除术(PTED)联合纤维环修复术治疗中青年单节段腰椎间盘突出症(LDH)的临床效果。

方法

回顾性研究选取2021年3月至2022年11月在保定市第一中心医院收治的96例单节段LDH患者。根据不同手术方式将患者分为内镜组和联合组。比较两组患者的手术情况、视觉模拟评分(VAS)和腰椎功能障碍指数(ODI)评分以及术后复查结果。

结果

内镜组50例,平均手术时间为43.68±10.77分钟,平均术中出血量为35.38±10.02毫升,手术节段复发7例,手术节段术后椎间不稳10例。联合组46例,平均手术时间为52.26±8.39分钟,平均术中出血量为39.23±9.02毫升,手术节段复发1例,手术节段椎间不稳2例。两组患者的手术时间(t=-4.328,P<0.01)、术后复发例数(χ=4.386,P<0.05)和椎间不稳例数(χ=5.366,P<0.05)差异有统计学意义。两组术中出血量差异无统计学意义(t=-1.965,P>0.05)。术后6个月,两组VAS和ODI评分差异有统计学意义。此外,两组患者术后各时间点的VAS评分和ODI评分与术前比较差异有统计学意义(P<0.05)。

结论

PTED联合纤维环修复术的临床疗效优于单纯PTED,可减少手术节段复发和椎间不稳的发生,提示PTED联合纤维环修复术在临床实践中可能值得推广。

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