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全内镜下腰椎间盘间切除术与腰椎显微椎间盘切除术的对比分析

Comparative Analysis of Full Endoscopic Interlaminar Lumbar Discectomy and Lumbar Microdiscectomy.

作者信息

Şerifoğlu Luay, Etli Mustafa Umut, Özdoğan Selçuk

机构信息

Department of Neurosurgery, Ümraniye Training and Research Hospital, İstanbul, Turkey.

出版信息

Clin Spine Surg. 2025 Jul 1;38(6):E312-E315. doi: 10.1097/BSD.0000000000001733. Epub 2024 Nov 18.

Abstract

STUDY DESIGN

Retrospective clinical study.

OBJECTIVES

The aim is to assess and contrast the results of full endoscopic lumbar discectomy (FELD) and lumbar microdiscectomy (LMD) for L5-S1 disc herniation, with a specific emphasis on postoperative pain reduction and surgical effectiveness.

BACKGROUND

Although minimally invasive spine operations are becoming more popular, there is still little research on the comparative effectiveness of FELD and LMD.

MATERIALS AND METHODS

The research had a total of 50 patients who received surgical intervention for L5-S1 disc herniation, with 25 patients getting full endoscopic interlaminar discectomy and the other 25 patients undergoing LMD. Clinical outcomes were assessed using the Visual Analog Scale for low back and leg pain, collected preoperatively and at the end of 1 week, 3 months, and 6 months postsurgery. Patient satisfaction was evaluated using Odoms criteria at the same intervals.

RESULTS

The study included 50 patients (26 men, 24 women), with a mean age of 51.11 ± 13.76 years. The groups had no significant differences in demographic data. Back and leg pain Visual Analog Scale scores decreased more significantly in the FELD group after 1 week of surgery ( P < 0.001), although the declines at 3 months and 6 months were not significantly different between the two groups. According to Odoms criteria, patient satisfaction was favorable in both groups and significantly better in the FELD group than in the LMD group at 1 week postoperatively [excellent in 20 patients (80%) in the FELD group vs 9 patients (36%) in the LMD group ( P = 0.025)]. However, patient satisfaction at 3 months and 6 months did not differ between the groups.

CONCLUSION

This study demonstrates that FELD offers significant early postoperative advantages over LMD at the L5-S1 level when compared with pain and satisfaction scales.

LEVEL OF EVIDENCE

Level III.

摘要

研究设计

回顾性临床研究。

目的

旨在评估和对比全内镜下腰椎间盘切除术(FELD)和腰椎显微椎间盘切除术(LMD)治疗L5-S1椎间盘突出症的结果,特别强调术后疼痛减轻情况和手术效果。

背景

尽管微创脊柱手术越来越受欢迎,但关于FELD和LMD对比效果的研究仍然很少。

材料与方法

该研究共有50例接受L5-S1椎间盘突出症手术干预的患者,其中25例行全内镜下椎间孔切开椎间盘切除术,另外25例行LMD。使用视觉模拟评分法评估术前、术后1周、3个月和6个月时的腰腿痛临床结局。在相同时间间隔使用奥多姆斯标准评估患者满意度。

结果

该研究纳入50例患者(26例男性,24例女性),平均年龄为51.11±13.76岁。两组在人口统计学数据方面无显著差异。FELD组术后1周时腰腿痛视觉模拟评分下降更显著(P<0.001),尽管两组在术后3个月和6个月时的下降情况无显著差异。根据奥多姆斯标准,两组患者满意度均良好,术后1周时FELD组明显优于LMD组[FELD组20例患者(80%)为优,LMD组9例患者(36%)为优(P=0.025)]。然而,两组在术后3个月和6个月时的患者满意度无差异。

结论

本研究表明,与疼痛和满意度量表相比,在L5-S1水平上,FELD在术后早期比LMD具有显著优势。

证据级别

三级。

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