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显微内镜下椎间盘切除术与经皮内镜下腰椎间盘切除术治疗青少年腰椎间盘突出症的疗效比较。

Comparison of the efficacy of microendoscopic discectomy and percutaneous endoscopic lumbar discectomy for treating adolescent lumbar disc herniation.

作者信息

Mao Lu, Shen Zicong, Zhu Weiye, Wang Kun, Fan Pan, Wu Xiaotao, Li Lijun, Liu Guanyi

机构信息

Department of Spine Surgery, Medical College, Zhongda Hospital, Southeast University, No. 87, Dingjiaqiao Road, Nanjing, Jiangsu, China.

Department of Orthopedics, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.

出版信息

Sci Rep. 2025 Mar 25;15(1):10185. doi: 10.1038/s41598-025-94635-5.

Abstract

Microendoscopic discectomy (MED) has long been employed as the standard operation for adolescent lumbar disc herniation (ALDH). However, due to iatrogenic injury, it has been suspected to cause adverse effects. Alternatively, percutaneous endoscopic lumbar discectomy (PELD) is considered as effective as MED. Few studies have compared MED and PELD in the treatment of ALDH. The purpose of this study was to compare the possible differences in young patients who underwent MED or PELD. From January 2011 to January 2021, 49 consecutive patients were treated with MED (17 patients) or PELD (32 patients) at the authors institution. Numeric Rating Scales (NRS) scores, Oswestry Disability Index (ODI) and modified MacNab criteria demonstrated significant improvement in both early and late follow-up evaluations (P < 0.01). PELD group resulted in shorter operative times and lower re-operation and complication rate. The PELD group exhibited shorter incision length, length of hospital stay and less intraoperative blood loss than the MED group. Both PELD and MED have demonstrated great efficacy in managing symptomatic ALDH. PELD appears to offer superior control over surgical trauma and promotes rapid recovery compared to MED.

摘要

显微内镜下椎间盘切除术(MED)长期以来一直被用作青少年腰椎间盘突出症(ALDH)的标准手术。然而,由于医源性损伤,人们怀疑它会产生不良影响。另外,经皮内镜下腰椎间盘切除术(PELD)被认为与MED一样有效。很少有研究比较MED和PELD在治疗ALDH方面的效果。本研究的目的是比较接受MED或PELD治疗的年轻患者之间可能存在的差异。2011年1月至2021年1月,作者所在机构连续对49例患者进行了MED(17例)或PELD(32例)治疗。数字评分量表(NRS)评分、Oswestry功能障碍指数(ODI)和改良MacNab标准在早期和晚期随访评估中均显示出显著改善(P<0.01)。PELD组手术时间更短,再次手术率和并发症发生率更低。与MED组相比,PELD组切口长度更短、住院时间更短且术中出血量更少。PELD和MED在治疗有症状的ALDH方面均显示出良好的疗效。与MED相比,PELD似乎能更好地控制手术创伤并促进快速康复。

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