体重指数对经皮椎间孔镜手术（PTES）治疗腰椎退行性疾病疗效及预后的影响：一项回顾性队列研究。
The influence of body mass index on efficacy and outcomes of percutaneous transforaminal endoscopic surgery (PTES) for the treatment of lumbar degenerative diseases: a retrospective cohort study.
作者信息
Zhuang Chenyang, Xu Yun, Lin Hong, Gu Yutong
机构信息
Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, PR China.
Department of Orthopaedic Surgery, Shanghai Geriatrics Centre, Shanghai, PR China.
出版信息
BMC Surg. 2025 Jan 16;25(1):28. doi: 10.1186/s12893-025-02761-8.
BACKGROUND
To investigate and quantify the influence of body mass index (BMI) on the efficacy and outcomes of percutaneous transforaminal endoscopic surgery (PTES), a novel minimally invasive surgical technique in the treatment of lumbar disc herniation (LDH).
METHODS
A total of 55 patients suffering from single-level LDH with or without high iliac crest, scoliosis or calcification, who underwent PTES in our department from January 2019 to December 2021 were retrospectively analyzed. Patients were divided into two groups according to BMI. The operative events of two groups including X-ray projection, operation time, blood loss and length of stay were compared. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy and outcomes of the surgery. Differences in complications and recurrences between two groups were also analyzed.
RESULTS
55 patients were divided into obese and nonobese groups according to their BMI (33.03 vs. 23.07). There was no significant difference in X-ray projection (times), operation time (mins), blood loss (mL) and length of stay (days) between two groups (7/5-11 vs. 5/5-10, 58.17 ± 9.20 vs. 53.65 ± 10.06, 6.41 ± 1.43 vs. 5.50 ± 2.45, 3.17 ± 1.44 vs. 2.96 ± 0.53, P > 0.05). Both groups demonstrated a significant decrease in ODI (12.01 ± 3.57% vs. 67.16 ± 9.25%, 13.92 ± 4.24% vs. 68.10 ± 9.27%, P < 0.05) and VAS (0.10 ± 0.48 vs. 8.38 ± 0.94, 0.22 ± 0.56 vs. 8.38 ± 0.86) at 24 months after the operation compared with which at the preoperative status. No significant difference in the improvement of the clinical outcomes was found between the two groups in ODI or VAS (P > 0.05).
CONCLUSIONS
With the simple orientation, easy puncture and reduced steps, PTES is an effective and safe method to both obese and normal patients with LDH.
CLINICAL TRIAL NUMBER
Not applicable.
背景
探讨并量化体重指数（BMI）对经皮椎间孔镜手术（PTES）疗效及预后的影响，PTES是一种治疗腰椎间盘突出症（LDH）的新型微创手术技术。
方法
回顾性分析2019年1月至2021年12月在我科接受PTES治疗的55例单节段LDH患者，这些患者伴有或不伴有髂嵴过高、脊柱侧弯或钙化。根据BMI将患者分为两组。比较两组的手术相关指标，包括X线透视次数、手术时间、出血量和住院时间。采用视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）评估手术的临床疗效及预后。分析两组并发症和复发情况的差异。
结果
55例患者根据BMI分为肥胖组和非肥胖组（33.03对23.07）。两组在X线透视次数（次）、手术时间（分钟）、出血量（毫升）和住院时间（天）方面无显著差异（7/5 - 11对5/5 - 10，58.17±9.20对53.65±10.06，6.41±1.43对5.50±2.45，3.17±1.44对2.96±0.53，P>0.05）。与术前相比，两组术后24个月时ODI[（12.01±3.57%对67.16±9.25%，13.92±4.24%对68.10±9.27%）]和VAS[（0.10±0.48对8.38±0.94，0.22±0.56对8.38±0.86）]均显著降低。两组在ODI或VAS的临床疗效改善方面无显著差异（P>0.05）。
结论
PTES定位简单、穿刺容易且步骤减少，对肥胖和正常的LDH患者都是一种有效且安全的方法。
临床试验编号
不适用。
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