经皮椎间孔镜技术联合胶原酶治疗包容型腰椎间盘突出症的临床疗效
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摘要
目的评价经皮椎间孔镜技术联合胶原酶治疗包容型腰椎间盘突出症的临床疗效。方法收集2015年1月至2017年1月在我院行经皮椎间孔镜联合胶原酶治疗的单节段包容型腰椎间盘突出症患者67例,随机分为单纯椎间孔镜组和联合胶原酶组。用视觉模拟评分法(VAS)及MacNab标准进行评价并比较两组治疗效果。结果两组患者手术后1日的VAS评分与术前比较差异有显著性(P <0.05),但两组在术后6个月的VAS评分比较差异有显著性(P <0.05),两组术后12个月的VAS评分差异有显著性(P <0.05),表现为联合组较单纯组疗效明显。按照改良MacNab疗效评定标准,联合胶原酶组治疗后12个月的优良率为82%,与单纯椎间孔镜组比较差异有显著性(P<0.05)。结论经皮椎间孔镜联合胶原酶和单纯经皮椎间孔镜治疗包容型腰椎间盘突出症均有效果,前者远期效果更佳。
Objective To evaluate the preliminary outcomes of percutaneous transforaminal endoscopic discectomy combined collagenase treating the nonparametric lumbar disc herniation. Methods Select 67 patients with single sigament lumbar disc prolapse type were randomly divided into intervertebral foramen and combined collagenase groups. The visual analogue scale(VAS) and MacNab criteria were used to evaluate the therapeutic effects of two groups. Results The VAS score of the two groups had significant difference between the post-operation and the pre-operation(P<0.05), the VAS score of the two groups had more significant difference in the post-operation 6 months(P<0.05), the post-operation VAS score of the two groups had significant difference in 6 months and in 12 months(P<0.05). According to the modified MacNab therapeutic effect evaluation standard, the proficiency was 82% after combined collagenase treatment group in 12 months, which had the significant difference compared with intervertebral foramen group(P<0.05). Conclusion The percutaneous intervertebral foramen endoscope combined collagenase and the percutaneous intervertebral foramen endoscope treating the lumbar intervertebral disc herniation are effective.
Objective To evaluate the preliminary outcomes of percutaneous transforaminal endoscopic discectomy combined collagenase treating the nonparametric lumbar disc herniation. Methods Select 67 patients with single sigament lumbar disc prolapse type were randomly divided into intervertebral foramen and combined collagenase groups. The visual analogue scale(VAS) and MacNab criteria were used to evaluate the therapeutic effects of two groups. Results The VAS score of the two groups had significant difference between the post-operation and the pre-operation(P<0.05), the VAS score of the two groups had more significant difference in the post-operation 6 months(P<0.05), the post-operation VAS score of the two groups had significant difference in 6 months and in 12 months(P<0.05). According to the modified MacNab therapeutic effect evaluation standard, the proficiency was 82% after combined collagenase treatment group in 12 months, which had the significant difference compared with intervertebral foramen group(P<0.05). Conclusion The percutaneous intervertebral foramen endoscope combined collagenase and the percutaneous intervertebral foramen endoscope treating the lumbar intervertebral disc herniation are effective.
引文
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[9]LiYW,WangHJ,WangYS,etal.Comparisonofpercutaneous endoscopiclumbardiscectomyversustransforaminallumbar interbodyfusionintreatingupperlumbardischerniation[J].Zhonghua Yi Xue Za Zhi,2018,98(2):113-116.
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[11]宋超,池永龙,陈雪松,等.侧路非同轴椎间盘镜在腰椎椎间盘切吸术中的应用[J].脊柱外科杂志,2012,10(1):6-8.
[12]巨辉,白国强,杨磊,等.胶原酶髓核溶解术和椎间孔镜术治疗腰椎间盘突出症疗效对比[J].医学综述,2015,21(19):3640-3642.
[13]赵骞.盘内注射胶原酶治疗腰椎间盘突出症介入术后疼痛的临床观察[J].医学综述,2012,18(22):3912-3913.
[2]吴信波,范国鑫,管晓菲,等.经椎间孔入路经皮内窥镜下腰椎椎间盘切除术治疗高位腰椎椎间盘突出症[J].脊柱外科杂志,2016,14(5):257-261.
[3]Lee KH,Yue WM,Yeo W,et al.Clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion[J].Eur Spine J,2012,21(11):2265-2270.
[4]Foley KT SMM.Microendoscopic discectomy[J].Tech Neurosurg,1997,3(3):301-307.
[5]KarakasliA.Biomechanicalcomparisonofintactlumbarlamb spineandendoscopicdiscectomizedlambspine[J].Eklem Hastalik Cerrahisi,2013,24(1):33-38.
[6]邱鹏程,刘剑芬,潘略韬,等.不同微创疗法联合胶原酶在腰椎间盘突出症治疗中的应用[J].广东医学,2016,37(S1):105-107.
[7]MacNab I.Negative disc exploration an analysis of the causes of nerve-root involvement in sixty-eight patients[J].J Bone Joint Surg Am,1971,53(5):891-903.
[8]段丽群,张文志,贺瑞,等.经皮椎间孔镜下髓核摘除术治疗脱垂移位型腰椎间盘突出症的临床疗效[J].中国矫形外科杂志,2016,24(15):1368-1374.
[9]LiYW,WangHJ,WangYS,etal.Comparisonofpercutaneous endoscopiclumbardiscectomyversustransforaminallumbar interbodyfusionintreatingupperlumbardischerniation[J].Zhonghua Yi Xue Za Zhi,2018,98(2):113-116.
[10]MaheshaK.Percutaneousendoscopiclumbardiscectomy:Results of first 100 cases[J].Indian J Orthop,2017,51(1):36-42.
[11]宋超,池永龙,陈雪松,等.侧路非同轴椎间盘镜在腰椎椎间盘切吸术中的应用[J].脊柱外科杂志,2012,10(1):6-8.
[12]巨辉,白国强,杨磊,等.胶原酶髓核溶解术和椎间孔镜术治疗腰椎间盘突出症疗效对比[J].医学综述,2015,21(19):3640-3642.
[13]赵骞.盘内注射胶原酶治疗腰椎间盘突出症介入术后疼痛的临床观察[J].医学综述,2012,18(22):3912-3913.