摘要
目的探讨经皮内镜椎板间入路手术治疗脱垂型腰椎间盘突出症的临床疗效。方法回顾性分析泸州市人民医院2019年3月至2021年9月行手术治疗的脱垂型腰椎间盘突出症患者66例的临床资料,依据手术方式分为后入路开放腰椎间盘切除术(OLM组)29例、经皮内镜下椎板间入路腰椎间盘切除术(PEID组)37例,比较两组患者围手术期情况,记录术前及术后1周、1个月、3个月、6个月、12个月的腿痛视觉模拟评分法(VAS)评分及Oswestry功能障碍指数(ODI)评分,末次随访时采用改良MacNab标准评定临床疗效。结果 OLM组手术时间、出血量、住院时间分别为(96.55±15.18)min、120.0(100.0,180.0)mL、10.0(9.5,12.0)d,PEID组分别为(77.30±11.03)min、20.0(15.0,22.5)mL、6.0(5.0,7.0)d,两组差异均有统计学意义(t=5.97,Z=-7.00、-6.68,均P<0.001)。两组术后1周、1个月、3个月、6个月、12个月腿痛VAS评分差异均无统计学意义(均P>0.05);术后1周、1个月、3个月,PEID组ODI评分分别为12.0(10.0,24.0)分、6.0(9.0,13.0)分、2.0(4.0,8.0)分,均低于OLM组的24.0(16.0,31.0)分、16.0(10.0,21.0)分、8.0(8.0,12.0)分(Z=-3.64、-3.79、-3.26,均P<0.05)。末次随访改良MacNab标准评定,OLM组优良率为86.21%(25/29),PEID组优良率为89.19%(33/37),两组差异无统计学意义(P>0.05)。结论 PEID治疗脱垂型腰椎间盘突出症的临床疗效满意。
Objective To investigate the clinical efficacy of percutaneous endoscopic interlaminar discectomy for lumbar disc prolapse.Methods The clinical data of 60 patients with lumbar disc prolapse who underwent surgery at Luzhou People's Hospital between March 2019 and September 2021 were retrospectively analyzed.These patients were divided into an open lumbar discectomy(OLM)group(n=29,receiving treatment through a posterior approach)and a percutaneous endoscopic interlaminar discectomy(PEID)group(n=37).Perioperative conditions were compared between the two groups.The Visual Analogue Scale(VAS)and Oswestry Disability Index scores of the leg were recorded before surgery and 1 week,1,3,6 and 12 months after surgery.At the final follow-up,clinical efficacy was assessed using the modified MacNab criteria.Results The surgical time,blood loss,and length of hospital stay were(96.55±15.18)minutes,120.0(100.0,180.0)mL,and 10.0(9.5,12.0)days in the OLM group,while these values were(77.30±11.03)minutes,20.0(15.0,22.5)mL,and 6.0(5.0,7.0)days in the PEID group,respectively.Significant differences were observed in these indexes between the two groups(t=5.97,Z=-7.00,-6.68,all P<0.001).At 1 week,1 month,3 months,6 months,and 12 months after surgery,there was no significant difference in VAS score between the two groups(all P>0.05).At 1 week,1 month,and 3 months after surgery,the Oswestry Disability Index score in the PEID group was 12.0(10.0,24.0)points,6.0(9.0,13.0)points,and 2.0(4.0,8.0)points,respectively,which were significantly lower than 24.0(16.0,31.0)points,16.0(10.0,21.0)points,and 8.0(8.0,12.0)points in the OLM group,respectively(Z=-3.64,-3.79,-3.26,all P<0.05).According to the modified MacNab criteria for final follow-up assessment,the excellent and good rate was 86.21%(25/29)in the OLM group and 89.19%(33/37)in the PEID group;there was no significant difference in excellent and good rate between the two groups(P>0.05).Conclusion The clinical efficacy of PEID in the treatment of lumbar disc prolapse is satisfactory.
作者
冯鑫剑
易生辉
席殿梅
李倩茹
Feng Xinjian;Yi Shenghui;Xi Dianmei;Li Qianru(Department of Spine Surgery,Luzhou People's Hospital,Luzhou 646000,Sichuan Province,China;Third Department of Orthopedics,Yueyang Hospital of Traditional Chinese Medicine,Yueyang 414000,Hunan Province,China;Department of Endocrinology and Metabolism,Luzhou People's Hospital,Luzhou 646000,Sichuan Province,China)
出处
《中国基层医药》
CAS
2023年第12期1773-1777,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
椎间盘移位
腰椎
椎间盘切除术
经皮内镜下椎板间入路腰椎间盘切除术
疼痛测定
手术后并发症
疗效比较研究
回顾性研究
Intervertebral disc displacement
Lumbar vertebrae
Diskectomy
Percutaneous endoscopic lumbar discectomy via inter-laminar approach
Pain measurement
Postoperative complications
Comparative effectiveness research
Retrospective studies
