横突在经椎间孔脊柱内窥镜手术中的作用
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摘要
目的 分析横突在经腰椎间孔脊柱内窥镜手术中的作用。方法 通过一定纳入标准筛选2015年9月至2016年5月接受椎间孔镜治疗的腰椎间盘突出症患者,以横突为参照物制定手术方案,通过术前术后VAS、ODI评分的配对t检验评价手术效果。结果 手术患者共68例,男42例,女26例;年龄28～53岁,平均年龄38岁;其中腰3/4节段3例,腰4/5节段41例,腰5/骶1节段24例。均成功利用横突实施手术。术前VAS、ODI评分值与术后6个月VAS、ODI评分值比较差异有统计学意义(P<0.05)。结论 横突在椎间孔扩大成形过程中,可作为骨性标志参考,帮助评估骨钻安全位置,完成椎间孔扩大成型。
Objective To analyze the role of transverse process in intervertebral foramen spinal column endoscopic surgery.Methods The patients with lubar intervertebral disc protrusion who were treated by transforaminal endoscopic surgery in our hospital from September 2015 to May 2016 were enrolled in the study, who were treated by surgery accoring to the surgery scheme by taking ransverse process as reference marker. The operation effects were evaluated by matching t test with VAS and ODI scores before and after operation.Results A total of 68 patients underwent surgical treatment including 42 males and 26 females, aged from 28 to 53 years, with an average age being 38 years, of whom, 3 cases in the lumbar 3/4 section, 41 cases in the lumbar 4/5 section, and 24 cases in the L5/S1. All the patients were successfully operated by using the transverse process as marker. There were significantly differences in the scores of VAS and ODI before operation and at six months after operation(P<0.05).Conclusion The transverse process can be used as a marker of bone reference during the expansion of intervertebral foramen, which is helpful to evaluate and adjust the position of bone drill and to complete the expansion of intervertebral pore.
Objective To analyze the role of transverse process in intervertebral foramen spinal column endoscopic surgery.Methods The patients with lubar intervertebral disc protrusion who were treated by transforaminal endoscopic surgery in our hospital from September 2015 to May 2016 were enrolled in the study, who were treated by surgery accoring to the surgery scheme by taking ransverse process as reference marker. The operation effects were evaluated by matching t test with VAS and ODI scores before and after operation.Results A total of 68 patients underwent surgical treatment including 42 males and 26 females, aged from 28 to 53 years, with an average age being 38 years, of whom, 3 cases in the lumbar 3/4 section, 41 cases in the lumbar 4/5 section, and 24 cases in the L5/S1. All the patients were successfully operated by using the transverse process as marker. There were significantly differences in the scores of VAS and ODI before operation and at six months after operation(P<0.05).Conclusion The transverse process can be used as a marker of bone reference during the expansion of intervertebral foramen, which is helpful to evaluate and adjust the position of bone drill and to complete the expansion of intervertebral pore.
引文
1 杜明奎,管大伟,匡正达,等.经皮椎间孔镜技术治疗老年腰椎间盘突出症.中国骨与关节损伤杂志,2018,33:58-59.
2 古伟文,徐峰,蔡贤华,等.经皮椎间孔镜靶向穿刺技术治疗腰椎椎间盘突出症的疗效分析.脊柱外科杂志,2013,11:149-153.
3 Choi KC,Lee JH,Kim JS,et al.Unsuccessful percutaneous endoscopic lumbar discectomy:a single-center experience of 10,228 cases.Neurosurgery,2015,76:372-380.
4 刘丰平,赵红卫,陈海丹,罗茗刈.TESSYS椎间孔镜治疗腰椎间盘突出症的学习曲线及经验.中国矫形外科杂志,2016,24:235-241.
5 Yoshimura N.Epidemiology of osteoarthritis in Japan:the ROAD study.Clin Calcium,2011,21:821-825.
6 Kim DH,Cho SS,Moon YJ,et al.Factors Associated with Successful Responses to Transforaminal Balloon Adhesiolysis for Chronic Lumbar Foraminal Stenosis:Retrospective Study.Pain Physician,2017,20:841-848.
7 甄瑞鑫,李玉波,宋有鑫,等.椎下切迹的测量分析对经椎间孔入路的脊柱内镜技术的意义.实用骨科杂志,2017,23:879-883.
8 Abe M,Takata Y,Higashino K,et al.Foraminoplastic transforaminal percutaneous endoscopic discectomy at the lumbosacral junction under local anesthesia in an elite rugby player.J Med Invest,2015,62:238-241.
9 Lee SH,Kang HS,Choi G,et al.Foraminoplastic ventral epidural approach for removal of extruded herniated fragment at the L5-S1 level.Neurol Med Chir (Tokyo),2010,50:1074-1078.
10 Eun SS,Lee SH,Liu WC,et al.A novel preoperative trajectory evaluation method for I5-S1 transforaminal percutaneous endoscopic lumbar discectomy.Spine J,2018,18:1286-1291.
11 Kapetanakis S,Gkasdaris G,Angoules AG,et al.Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique:Pitfalls that a beginner should avoid.World J Orthop,2017,8:874-880.
12 Schubert M,Hoogland T.Endoscopic transforaminal nucleotomy with foraminoplasty for lumbar disk herniation.Oper Orthop Traumatol,2005,17:641-661.
13 Sclafani JA,Kim CW.Complications associated with the initial learning curve of minimally invasive spine surgery:a systematic review.Clin Orthop Relat Res,2014,472:1711-1717.
14 Fan G,Wang T,Hu S,et al.Isocentric Navigation of Percutaneous Endoscopic Transforaminal Discectomy at the L5/S1 Level in Difficult Puncture Cases:A Technical Note.Pain Physician,2017,20:531-540.
15 Tezuka F,Sakai T,Abe M,et al.Anatomical considerations of the iliac crest on percutaneous endoscopic discectomy using a transforaminal approach.Spine J,2017,17:1875-1880.
2 古伟文,徐峰,蔡贤华,等.经皮椎间孔镜靶向穿刺技术治疗腰椎椎间盘突出症的疗效分析.脊柱外科杂志,2013,11:149-153.
3 Choi KC,Lee JH,Kim JS,et al.Unsuccessful percutaneous endoscopic lumbar discectomy:a single-center experience of 10,228 cases.Neurosurgery,2015,76:372-380.
4 刘丰平,赵红卫,陈海丹,罗茗刈.TESSYS椎间孔镜治疗腰椎间盘突出症的学习曲线及经验.中国矫形外科杂志,2016,24:235-241.
5 Yoshimura N.Epidemiology of osteoarthritis in Japan:the ROAD study.Clin Calcium,2011,21:821-825.
6 Kim DH,Cho SS,Moon YJ,et al.Factors Associated with Successful Responses to Transforaminal Balloon Adhesiolysis for Chronic Lumbar Foraminal Stenosis:Retrospective Study.Pain Physician,2017,20:841-848.
7 甄瑞鑫,李玉波,宋有鑫,等.椎下切迹的测量分析对经椎间孔入路的脊柱内镜技术的意义.实用骨科杂志,2017,23:879-883.
8 Abe M,Takata Y,Higashino K,et al.Foraminoplastic transforaminal percutaneous endoscopic discectomy at the lumbosacral junction under local anesthesia in an elite rugby player.J Med Invest,2015,62:238-241.
9 Lee SH,Kang HS,Choi G,et al.Foraminoplastic ventral epidural approach for removal of extruded herniated fragment at the L5-S1 level.Neurol Med Chir (Tokyo),2010,50:1074-1078.
10 Eun SS,Lee SH,Liu WC,et al.A novel preoperative trajectory evaluation method for I5-S1 transforaminal percutaneous endoscopic lumbar discectomy.Spine J,2018,18:1286-1291.
11 Kapetanakis S,Gkasdaris G,Angoules AG,et al.Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique:Pitfalls that a beginner should avoid.World J Orthop,2017,8:874-880.
12 Schubert M,Hoogland T.Endoscopic transforaminal nucleotomy with foraminoplasty for lumbar disk herniation.Oper Orthop Traumatol,2005,17:641-661.
13 Sclafani JA,Kim CW.Complications associated with the initial learning curve of minimally invasive spine surgery:a systematic review.Clin Orthop Relat Res,2014,472:1711-1717.
14 Fan G,Wang T,Hu S,et al.Isocentric Navigation of Percutaneous Endoscopic Transforaminal Discectomy at the L5/S1 Level in Difficult Puncture Cases:A Technical Note.Pain Physician,2017,20:531-540.
15 Tezuka F,Sakai T,Abe M,et al.Anatomical considerations of the iliac crest on percutaneous endoscopic discectomy using a transforaminal approach.Spine J,2017,17:1875-1880.