Ding Shuai, Zhang Guangquan, Gao Yanzheng, Hou Zhiqiang, Shao Fuqiang
Department of Spine and Spinal Cord Surgery, Henan Provincial People's Hospital; People's Hospital of Zhengzhou University; People's Hospital of Henan University, Zhengzhou, China.
Pain Physician. 2024 Nov;27(8):E873-E879.
Discal cysts, an uncommon condition, can replicate the characteristic signs typically linked to a herniated lumbar disc, encompassing discomfort in the lumbar region and neuralgia that extends along the nerve paths, thereby complicating the process of distinguishing the discal cyst from other conditions. Consensus on the treatment of this disease remains elusive, and the best treatment for it is still a matter of controversy. In numerous past reports, this disease has been treated through either open or microscopic surgical approaches.
The aim of this study is to assess the therapeutic efficacy and safety of a minimally invasive endoscopic surgery technique in the treatment of lumbar discal cysts.
We conducted a retrospective observational analysis.
This research was initiated with a group of patients selected from the Spinal Surgery Unit at the Henan Provincial People's Hospital.
From March 2017 to May 2021, a minimally invasive endoscopic procedure was executed on a cohort of 7 male patients (average age: 30.86 ± 5.24 years), each diagnosed with discal cysts, within our spinal surgery division. The efficacy of the treatment was gauged by pre- and postoperative assessments that used the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). Furthermore, the ultimate clinical efficacy of the procedure was appraised in accordance with the revised Macnab criteria.
The patients reported a prompt and significant relief of symptoms after the surgical removal of the lumbar disc lesions, with no cases of recurrence noted during the follow-up period. A significant drop was observed in the VAS score for lower limb pain, declining from a preoperative mean of 6.86 ± 1.35 to 1.57 ± 0.53 at the final evaluation (P < 0.05). In tandem with this finding, a marked decrease in the ODI score was noted, with a reduction from 69.14 ± 10.76 before surgery to 10.29 ± 5.59 at the concluding review (P < 0.05). The postoperative VAS and ODI scores collectively pointed toward substantial improvements in patients' conditions. When assessed according to the revised Macnab criteria, the outcomes were distributed as follows: 4 patients (57.1%) achieved excellent results, 2 (28.6%) had very good results, and one (14.3%) had a fair result, totaling 6 patients (85.7%) with satisfactory outcomes. No severe complications or recurrences were identified during the postoperative monitoring phase.
This observational retrospective study was based on a convenience sampling that involved a limited number of patients.
Percutaneous endoscopic resection emerged as a micro-invasive and secure surgical approach for the management of lumbar discal cysts.
椎间盘囊肿是一种罕见病症，可表现出通常与腰椎间盘突出症相关的典型体征，包括腰部疼痛以及沿神经路径延伸的神经痛，这使得将椎间盘囊肿与其他病症区分开来的过程变得复杂。关于这种疾病的治疗尚未达成共识，其最佳治疗方法仍存在争议。在众多以往的报告中，这种疾病通过开放手术或显微手术方法进行治疗。
本研究的目的是评估微创内镜手术技术治疗腰椎间盘囊肿的疗效和安全性。
我们进行了一项回顾性观察分析。
本研究始于从河南省人民医院脊柱外科挑选的一组患者。
2017年3月至2021年5月，我们脊柱外科对7名男性患者（平均年龄：30.86±5.24岁）进行了微创内镜手术，每名患者均被诊断为椎间盘囊肿。通过使用视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）的术前和术后评估来衡量治疗效果。此外，根据修订的Macnab标准评估该手术的最终临床疗效。
手术切除腰椎间盘病变后，患者报告症状迅速且显著缓解，随访期间无复发病例。观察到下肢疼痛的VAS评分显著下降，术前平均为6.86±1.35，最终评估时降至1.57±0.53（P<0.05）。与此同时，ODI评分显著降低，从手术前的69.14±10.76降至最终复查时的10.29±5.59（P<0.05）。术后VAS和ODI评分共同表明患者状况有实质性改善。根据修订的Macnab标准评估，结果分布如下：4例患者（57.1%）取得优异结果，2例（28.6%）取得非常好的结果，1例（14.3%）取得尚可的结果，共有6例患者（85.7%）获得满意结果。术后监测阶段未发现严重并发症或复发。
这项观察性回顾性研究基于便利抽样，涉及的患者数量有限。
经皮内镜切除术是一种微创且安全的手术方法，用于治疗腰椎间盘囊肿。
