经皮椎间孔镜TESSYS技术治疗腰椎间盘突出症的疗效观察

Cinical effect of TESSYS technique of percutaneous transforaminal endoscopic discectomy for lumbar disc herniation

目的 观察经皮椎间孔镜TESSYS技术治疗腰椎间盘突出症的临床疗效.方法 175例腰椎间盘突出症患者随机分为两组,观察组80例采用椎间孔镜TESSYS技术治疗,对照组95例采用小切口腰椎间盘髓核摘除术治疗,两组随访时间为6～ 13个月,平均8个月,比较两组疗效.结果 根据Macnab疗效评定标准,观察组优良率（76.3％）明显高于对照组（61.1％）（P＜0.05）；观察组术中出血量少于对照组,手术切口长度短于对照组（P＜0.05）；两组患者术后VAS和ODI评分较术前明显改善（P＜0.05）,观察组改善更为显著（P＜0.05）.结论 经皮椎间孔镜TESSYS技术是治疗腰椎间盘突出症的有效方法,具有手术切口小,术中出血量少,术后腰痛程度轻,腰部功能恢复好等优点,值得临床推广应用.

Objective To observe the clinical effects of transforaminal endoscopic surgical system （TESSYS） technique of percutaneous transforaminal endoscope discectomy for lumbar disc herniation.Methods A total of 175 patients with lumbar disc herniation were randomly divided into 2 groups.Patients in the observation group（n =80 cases）were treated with TESSYS technique and patients in the control group（n =95 cases）were treated with microendoscopic discectomy system（MED） technique.The follow-up period ranged from 6 to 13 months with an average of 8 months.Clinical effects were compared between the groups.Results According to the MacNab standard,the excellent rate of the observation group（76.3％）was significantly higher than that of conventional operation group （61.1％） （P ＜ 0.05）.The bleeding volume,operation time and incision length of the observation group was significantly better than that of the control group（P ＜ 0.05）.The postoperative VAS and ODI scores of the two groups were significantly improved（P ＜ 0.05）,and the observation group improved much more significant（P ＜ 0.05）.Conclusion The TESSYS technique of percutaneous transforaminal endoscope discectomy was an effective method for lumbar disc herniation.It has the advantages of small incision,less bleeding,light postoperative pain and better waist function recovery,which is worthy of spreading for clinical application.