经皮椎间孔镜下TESSYS技术治疗游离型腰椎间盘突出症
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摘要
目的探讨经皮椎间孔镜下TESSYS技术并椎间孔成形术治疗游离型腰椎间盘突出症(LDH)的疗效。方法采用经皮椎间孔镜下TESSYS技术并椎间孔成形术治疗80例游离型LDH患者,通过ODI评分与VAS评分对治疗效果进行评估。结果手术时间为37～75(57. 8±14. 8) min,术中出血量为29～51(39. 8±7. 2)ml。患者均未出现椎旁血肿、伤口感染以及神经损伤等并发症。患者均获得12个月的随访。患者VAS评分和ODI评分术后3 d及1、3、6、12个月各时间点均较术前显著下降(P <0. 05),并且术后1、3、6、12个月均较术后3 d进一步降低(P <0. 05)。结论经皮椎间孔镜下TESSYS技术并椎间孔成形术治疗游离型LDH近期疗效显著。
Objective To investigate the clinical efficacy of percutaneous transforaminal endoscopic TESSYS technique and intervertebral foramen plasty for the treatment of free lumbar disc herniation( LDH). Methods The 80 cases of free LDH patients were treated with endoscopic TESSYS technique and intervertebral foramen plasty. The therapeutic effects of ODI and VAS were evaluated. Results The operation time was 37 ～ 75( 57. 8 ± 14. 8) min,and the intraoperative blood loss was 29 ～ 51( 39. 8 ± 7. 2) ml. None of the patients had complications such as paraspinal hematoma,wound infection,and nerve injury. All patients were followed up for 12 months. The VAS and ODI scores of patients at 3 d,1,3,6,12 months after surgery were significantly decreased than those before surgery( P < 0. 05),and were significantly lower at 1,3,6,12 months than 3 d after surgery( P < 0. 05). Conclusions Percutaneous transforaminal endoscopic TESSYS and intertebral foramen plasty for the treatment of free LDH has a significant short-term effect.
Objective To investigate the clinical efficacy of percutaneous transforaminal endoscopic TESSYS technique and intervertebral foramen plasty for the treatment of free lumbar disc herniation( LDH). Methods The 80 cases of free LDH patients were treated with endoscopic TESSYS technique and intervertebral foramen plasty. The therapeutic effects of ODI and VAS were evaluated. Results The operation time was 37 ～ 75( 57. 8 ± 14. 8) min,and the intraoperative blood loss was 29 ～ 51( 39. 8 ± 7. 2) ml. None of the patients had complications such as paraspinal hematoma,wound infection,and nerve injury. All patients were followed up for 12 months. The VAS and ODI scores of patients at 3 d,1,3,6,12 months after surgery were significantly decreased than those before surgery( P < 0. 05),and were significantly lower at 1,3,6,12 months than 3 d after surgery( P < 0. 05). Conclusions Percutaneous transforaminal endoscopic TESSYS and intertebral foramen plasty for the treatment of free LDH has a significant short-term effect.
引文
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[9]张西峰,王岩,肖嵩华,等.经皮侧方入路内窥镜下椎间盘切除术的可行性及临床应用[J].中国脊柱脊髓杂志,2016,16(9):659-662.
[10]顾勇杰,陈其昕.经皮内镜下腰椎间盘切除术[J].国际骨科学杂志,2016,27(4):216-218.
[11]徐少克.经皮内窥镜下手术治疗复发性腰椎盘突出症[J].中国脊柱脊髓杂志,2010,20(7):541-543.
[12]何升华,孙志涛,马笃军,等.经皮椎间孔镜YESS与TESSYS技术结合治疗多节段腰椎间盘突出症[J].临床骨科杂志,2015,18(4):398-401.
[13]杨五洲,曹奇,杨铁军.经皮椎间孔镜治疗腰椎间盘突出症的临床应用[J].实用医学杂志,2016,56(4):16-23.
[2]吴锐辉,廖绪强,赵新建,等. TESSYS髓核摘除及椎间孔成型术治疗腰椎间盘突出合并侧隐窝狭窄症[J].现代中西医结合杂志,2015,22(10):1083-1085.
[3]张达颖,章勇,刘小健,等. TESSYS技术治疗中央型腰椎间盘突出并椎管狭窄症回顾性分析[J].中国疼痛医学杂志,2015,23(4):270-274.
[4]沙宇,周红刚,马海军,等.经皮椎间孔镜在腰椎间盘突出症治疗中的应用[J].实用骨科杂志,2015,12(5):437-439.
[5]胡德新,郑琦,朱博,等.经皮椎间孔镜下选择性减压治疗老年性腰椎管狭窄症的疗效分析[J].中国骨伤,2014,19(3):194-198.
[6]吴闻文,李振宙,侯树勋.侧后路经椎间孔镜下髓核摘除、射频热凝纤维环成形术治疗椎间盘源性腰痛[J].中国脊柱脊髓杂志,2016,18(2):123-126.
[7] Choi K C,Lee J H,Kim J S. Unsuccessful percutaneous endoscopic lumbar discectomy:A single-center experience of 10 228cases[J]. Neurosurgery,2015,76(4):372-380.
[8]周跃,李长青,王建,等.椎间孔镜YESS与TESSYS技术治疗腰椎间盘突出症[J].中华骨科杂志,2010,30(3):225-231.
[9]张西峰,王岩,肖嵩华,等.经皮侧方入路内窥镜下椎间盘切除术的可行性及临床应用[J].中国脊柱脊髓杂志,2016,16(9):659-662.
[10]顾勇杰,陈其昕.经皮内镜下腰椎间盘切除术[J].国际骨科学杂志,2016,27(4):216-218.
[11]徐少克.经皮内窥镜下手术治疗复发性腰椎盘突出症[J].中国脊柱脊髓杂志,2010,20(7):541-543.
[12]何升华,孙志涛,马笃军,等.经皮椎间孔镜YESS与TESSYS技术结合治疗多节段腰椎间盘突出症[J].临床骨科杂志,2015,18(4):398-401.
[13]杨五洲,曹奇,杨铁军.经皮椎间孔镜治疗腰椎间盘突出症的临床应用[J].实用医学杂志,2016,56(4):16-23.