经皮椎间孔镜技术与小切口椎板开窗髓核摘除术治疗腰椎间盘突出症的疗效比较

Comparison effect of percutaneous transforaminal endoscopic discectomy and small incision laminectomy in the treatment of lumbar disc herniation

目的比较经皮椎间孔镜技术与小切口椎板开窗髓核摘除术治疗腰椎间盘突出症疗效。方法将166例腰椎间盘突出症患者随机分为两组,每组83例,对照组采用小切口椎板开窗髓核摘除术,观察组采用经皮椎间孔镜技术。比较两组手术相关指标、疼痛缓解和功能恢复情况、临床疗效及并发症发生情况。结果患者均获得3个月随访。切口长度、手术时间、术中出血量及住院时间观察组均优于对照组(P <0. 001)。术后3个月,两组VAS评分、JOA评分及临床治疗有效率比较差异均无统计学意义(P> 0. 05)。并发症发生率观察组低于对照组(P <0. 05)。结论经皮椎间孔镜技术与小切口椎板开窗髓核摘除术治疗腰椎间盘突出症临床疗效相当,但经皮椎间孔镜技术损伤少,并发症少,住院时间短。

Objective To compare the efficacy of percutaneous transforaminal endoscopic discectomy and small incision laminectomy in the treatment of lumbar disc herniation.Methods The 166 patients with lumbar disc herniation were randomly divided into two groups,each group 83 cases,the patients in the control group were treated with discectomy of small incision laminectomy,and the patients in the observation group were treated with percutaneous transforaminal microscopy technique.The operation related indicators,pain relief,functional recovery,clinical efficacy and complications were compared between the two groups.Results All patients were followed up for 3 months.The incision length,operative time,intraoperative bleeding volume,hospitalization time in the observation group were superior to those in the control group(P<0.001).At 3 months after operation,there were not statistical difference for VAS,JOA score and clinical efficacy between two groups(P<0.05).The incidence rate of complications in the observation group was lower than that in the control group(P<0.05).Conclusions Percutaneous transforaminal endoscopy and small incision fenestration for lumbar disc herniation have the same clinical effect,but percutaneous transforaminal endoscopy has less trauma,fewer complications and shorter hospital stay.