椎间盘镜与椎间孔镜治疗腰椎间盘突出症的临床分析

Clinical analysis of micro-endoscopic discectomy and percutaneous endoscopic lumbar discectomy for the treatment of lumbar disc herniation

目的探讨椎间盘镜与椎间孔镜治疗腰椎间盘突出症(LDH)的临床疗效。方法回顾性分析120例LDH病人的临床资料,根据手术方式不同分为椎间盘镜组及椎间孔镜组各60例。比较两组术后优良率、并发症发生率以及术后视觉模拟评分(VAS)。结果椎间盘镜组术后优良率为95.0%,并发症3例(术后终板炎2例、残留椎间盘再突出1例),术后VAS评分(4.32±1.28)分。椎间孔镜组术后优良率为93.33%,并发症2例(术后神经根激惹1例、残留椎间盘再突出1例),术后VAS评分(4.67±1.29)分。两组术后优良率、并发症发生率、术后VAS评分差异均无统计学差异(P>0.05)。结论采用椎间盘镜与椎间孔镜手术治疗LDH均可获得理想效果,临床上可根据病人的具体病情选择适宜的手术方案。

Objective To explore the therapeutic efficacy of micro-endoscopic discectomy(MED) and percutaneous endoscopic lumbar discectomy(PELD) for the treatment of lumbar disc herniation(LDH). Methods Clinical data of 120 LDH patients were analyzed retrospectively, and the patents were divided into MED group and PELD group in 60 patients each according to the surgical method. The therapeutic effects, complication rate and visual analogue scale(VAS) scores between the two groups were compared after the operation. Results The excellent and good outcome rate after surgery was 95.0%, the complication occurred in 3 patients including postoperative endplate inflammation in 2 and residual disc herniation in 1, and the VAS scores were 4.32 ±1.28 in MED group. While the same rate after surgery was 93.33%, the complication occurred in 2 patients including nerve root irritation in 1 and residual disc herniation in 1, and the VAS scores were 4.67±1.29 in PELD group. No significant difference was found in the excellent and good outcome rate, the incidence rate of complication and postoperative VAS score between the two groups( P > 0. 05).Conclusion MED and PELD all can get ideal outcome in the treatment of LDH, and the appropriate surgical program can be selected based on the specific conditions of patients.