经皮椎间孔镜技术与小切口椎板开窗髓核摘除术治疗腰椎间盘突出症的疗效比较
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摘要
目的比较经皮椎间孔镜技术与小切口椎板开窗髓核摘除术治疗腰椎间盘突出症疗效。方法将166例腰椎间盘突出症患者随机分为两组,每组83例,对照组采用小切口椎板开窗髓核摘除术,观察组采用经皮椎间孔镜技术。比较两组手术相关指标、疼痛缓解和功能恢复情况、临床疗效及并发症发生情况。结果患者均获得3个月随访。切口长度、手术时间、术中出血量及住院时间观察组均优于对照组(P <0. 001)。术后3个月,两组VAS评分、JOA评分及临床治疗有效率比较差异均无统计学意义(P> 0. 05)。并发症发生率观察组低于对照组(P <0. 05)。结论经皮椎间孔镜技术与小切口椎板开窗髓核摘除术治疗腰椎间盘突出症临床疗效相当,但经皮椎间孔镜技术损伤少,并发症少,住院时间短。
Objective To compare the efficacy of percutaneous transforaminal endoscopic discectomy and small incision laminectomy in the treatment of lumbar disc herniation. Methods The 166 patients with lumbar disc herniation were randomly divided into two groups,each group 83 cases,the patients in the control group were treated with discectomy of small incision laminectomy,and the patients in the observation group were treated with percutaneous transforaminal microscopy technique. The operation related indicators,pain relief,functional recovery,clinical efficacy and complications were compared between the two groups. Results All patients were followed up for 3 months. The incision length,operative time,intraoperative bleeding volume,hospitalization time in the observation group were superior to those in the control group( P < 0. 001). At 3 months after operation,there were not statistical difference for VAS,JOA score and clinical efficacy between two groups( P > 0. 05). The incidence rate of complications in the observation group was lower than that in the control group( P < 0. 05). Conclusions Percutaneous transforaminal endoscopy and small incision fenestration for lumbar disc herniation have the same clinical effect,but percutaneous transforaminal endoscopy has less trauma,fewer complications and shorter hospital stay.
Objective To compare the efficacy of percutaneous transforaminal endoscopic discectomy and small incision laminectomy in the treatment of lumbar disc herniation. Methods The 166 patients with lumbar disc herniation were randomly divided into two groups,each group 83 cases,the patients in the control group were treated with discectomy of small incision laminectomy,and the patients in the observation group were treated with percutaneous transforaminal microscopy technique. The operation related indicators,pain relief,functional recovery,clinical efficacy and complications were compared between the two groups. Results All patients were followed up for 3 months. The incision length,operative time,intraoperative bleeding volume,hospitalization time in the observation group were superior to those in the control group( P < 0. 001). At 3 months after operation,there were not statistical difference for VAS,JOA score and clinical efficacy between two groups( P > 0. 05). The incidence rate of complications in the observation group was lower than that in the control group( P < 0. 05). Conclusions Percutaneous transforaminal endoscopy and small incision fenestration for lumbar disc herniation have the same clinical effect,but percutaneous transforaminal endoscopy has less trauma,fewer complications and shorter hospital stay.
引文
[1]江加义,吴波,长安定,等.经皮椎间孔镜技术与传统椎板间开窗髓核摘除术的疗效比较[J].临床医学,2017,37(6):67-69.
[2]中华医学会放射学分会介入学组.腰椎间盘突出症的介入和微创治疗操作规范的专家共识[J].中华放射学杂志,2014,48(1):10-12.
[3]张红鹤,赵柳絮,邓丽,等.经皮椎间孔镜椎间盘切除术与椎板开窗髓核摘除术对脊柱运动单位影响的对比研究[J].脊柱外科杂志,2015,13(4):223-227.
[4] Kreiner D S,Hwang S W,Easa J E,et al. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy[J]. Spine,2014,14(1):180-191.
[5]陈付强,于洋,杨文荣,等.经皮椎间孔镜技术治疗老年退变性腰椎管狭窄症的临床研究[J].中国疼痛医学杂志,2015,21(10):759-763.
[6] Tecer D,Adiguzel E,Tan A K,et al. Role of magnetic resonance imaging in ascertaining the success of transforaminal epidural steroid injection for lumbar radicular pain[J]. Pain Med,2017,18(4):645-650.
[7]段丽群,张文志,刘鹏飞,等.经皮椎间孔镜技术治疗极外侧型腰椎间盘突出症[J].颈腰痛杂志,2016,37(3):214-218.
[8]滑国田,袁志刚,赖茂文.椎间孔镜技术治疗腰椎间盘突出症的近期临床疗效分析[J].生物骨科材料与临床研究,2016,13(1):53-55.
[9]韩广,汤锋武,张赛,等.经皮椎间孔镜技术治疗腰椎间盘突出症和腰椎间孔狭窄的并发症原因分析与处理[J].中国现代神经疾病杂志,2016,16(4):210-215.
[10]聂治军,张文芳,张银刚.经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症的疗效分析[J].临床骨科杂志,2018,21(2):153-156.
[11]李兴艳,张津铭,叶亚平,等.经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的疗效对比[J].中国骨与关节损伤杂志,2015,30(5):467-469.
[12]孙凤龙,章耀华,李强,等.经皮椎间孔镜技术治疗腰椎间盘突出症的临床疗效观察[J].中国临床医生杂志,2016,44(2):75-78.
[13]陆龙卫,赵凯,王凌斌,等.经皮内镜下治疗腰椎间盘突出症的疗效观察[J].临床骨科杂志,2017,20(6):655-656.
[2]中华医学会放射学分会介入学组.腰椎间盘突出症的介入和微创治疗操作规范的专家共识[J].中华放射学杂志,2014,48(1):10-12.
[3]张红鹤,赵柳絮,邓丽,等.经皮椎间孔镜椎间盘切除术与椎板开窗髓核摘除术对脊柱运动单位影响的对比研究[J].脊柱外科杂志,2015,13(4):223-227.
[4] Kreiner D S,Hwang S W,Easa J E,et al. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy[J]. Spine,2014,14(1):180-191.
[5]陈付强,于洋,杨文荣,等.经皮椎间孔镜技术治疗老年退变性腰椎管狭窄症的临床研究[J].中国疼痛医学杂志,2015,21(10):759-763.
[6] Tecer D,Adiguzel E,Tan A K,et al. Role of magnetic resonance imaging in ascertaining the success of transforaminal epidural steroid injection for lumbar radicular pain[J]. Pain Med,2017,18(4):645-650.
[7]段丽群,张文志,刘鹏飞,等.经皮椎间孔镜技术治疗极外侧型腰椎间盘突出症[J].颈腰痛杂志,2016,37(3):214-218.
[8]滑国田,袁志刚,赖茂文.椎间孔镜技术治疗腰椎间盘突出症的近期临床疗效分析[J].生物骨科材料与临床研究,2016,13(1):53-55.
[9]韩广,汤锋武,张赛,等.经皮椎间孔镜技术治疗腰椎间盘突出症和腰椎间孔狭窄的并发症原因分析与处理[J].中国现代神经疾病杂志,2016,16(4):210-215.
[10]聂治军,张文芳,张银刚.经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症的疗效分析[J].临床骨科杂志,2018,21(2):153-156.
[11]李兴艳,张津铭,叶亚平,等.经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的疗效对比[J].中国骨与关节损伤杂志,2015,30(5):467-469.
[12]孙凤龙,章耀华,李强,等.经皮椎间孔镜技术治疗腰椎间盘突出症的临床疗效观察[J].中国临床医生杂志,2016,44(2):75-78.
[13]陆龙卫,赵凯,王凌斌,等.经皮内镜下治疗腰椎间盘突出症的疗效观察[J].临床骨科杂志,2017,20(6):655-656.