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一种预防复发性腰椎间盘突出症的新型疝封堵系统:手术技术、术中发现及术后六个月结果

A new hernia blocking system to prevent recurrent lumbar disc herniation: surgical technique, intraoperative findings and six-months post-operative outcomes.

作者信息

Godino Oscar, Fernandez-Carballal Carlos, Català Ignasi, Moreno Ángela, Rimbau Jordi Manuel, Alvarez-Galovich Luís, Roldan Héctor

机构信息

Neurosurgery Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.

Neurosurgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

出版信息

Eur Spine J. 2025 Mar;34(3):1123-1133. doi: 10.1007/s00586-024-08595-x. Epub 2024 Dec 8.

Abstract

PURPOSE

The aim of this study was to evaluate the performance and safety of a new hernia blocking system (HBS), implanted after a limited discectomy, to prevent recurrence of lumbar disc herniation.

METHODS

Prospective, multicenter (6 sites), cohort clinical investigation. Thirty patients with a postero-lateral disc herniation between L4-S1 and large annular defects (> 6 mm wide), who underwent a limited discectomy and were treated with a new HBS (DISC care, NEOS Surgery S.L.), were included. This article presents details about the investigational device, its surgical technique, intraoperative parameters, and up to 6 months follow-up outcomes. The primary endpoint of the study was to assess the incidence of early symptomatic reherniation. In addition, disc height, leg and back pain (NRS 0-10), Oswestry Disability Index (ODI), quality of life (EQ-5D-5L) and device safety, were evaluated.

CLINICALTRIALS

gov: NCT04188236; date: 27th November 2019.

RESULTS

Thirty patients (43.3% female, 41.7 ± 10.9 years) were implanted with the device under evaluation in a mean of 16 ± 9.6 min. Six months after surgery, no symptomatic reherniation was detected and disc height was maintained in all patients included. All patients had a significant reduction in leg pain (> 2 points in the NRS), 92.9% improved > 15 points in the ODI and 82.6% significantly improved their quality of life (≥ 12 points in EQ VAS score). No product-related serious adverse events nor reoperations occurred.

CONCLUSIONS

The implantation of an HBS is a feasible and safe procedure that prevents early disc herniation recurrence in patients at high risk of reherniation.

摘要

目的

本研究旨在评估一种新型疝封堵系统(HBS)在有限椎间盘切除术后植入,预防腰椎间盘突出症复发的性能和安全性。

方法

前瞻性、多中心(6个地点)队列临床研究。纳入30例L4-S1节段后外侧椎间盘突出且伴有较大椎间盘环缺损(>6mm宽),接受了有限椎间盘切除术并采用新型HBS(DISC care,NEOS Surgery S.L.)治疗的患者。本文介绍了研究装置的详细信息、其手术技术、术中参数以及长达6个月的随访结果。该研究的主要终点是评估早期有症状再突出的发生率。此外,还评估了椎间盘高度、腿部和背部疼痛(数字评分量表0-10)、奥斯威斯残疾指数(ODI)、生活质量(EQ-5D-5L)以及装置安全性。

临床试验

gov:NCT04188236;日期:2019年11月27日。

结果

30例患者(43.3%为女性,年龄41.7±10.9岁)接受了评估装置的植入,平均手术时间为16±9.6分钟。术后6个月,未检测到有症状的再突出,所有纳入患者的椎间盘高度均得以维持。所有患者的腿部疼痛均显著减轻(数字评分量表>2分),92.9%的患者奥斯威斯残疾指数改善>15分,82.6%的患者生活质量显著改善(EQ视觉模拟量表评分≥12分)。未发生与产品相关的严重不良事件,也未进行再次手术。

结论

植入HBS是一种可行且安全的手术方法,可预防再突出高风险患者的早期椎间盘突出复发。

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