经皮椎间孔镜不同进针技术治疗腰椎间盘突出症患者的效果对比

Comparison on the Effects of Percutaneous Transforaminal Endoscopy with Different Needle Insertion Techniques in the Treatment of Patients with Lumbar Disc Herniation

目的 对比经皮椎间孔镜不同进针技术治疗腰椎间盘突出症患者的临床效果。方法 选取2019年1月至2022年1月在我院行经皮椎间孔镜手术治疗的90例腰椎间盘突出症患者,随机分为两组各45例。对照组实施常规后入路进针,观察组实施后入路45°进针。比较两组的临床疗效、疼痛程度以及下肢功能。结果 两组的治疗优良率比较,差异无统计学意义(P>0.05)。观察组术后6个月、术后1年的VAS评分均显著低于对照组(P <0.05)。观察组术后1年的ODI评分显著低于对照组(P <0.05)。结论 经皮椎间孔镜手术经由常规后入路进针和后入路45°进针治疗腰椎间盘突出症的近期疗效相当,但后入路45°进针能够更明显地减轻患者术后远期疼痛,改善患者下肢功能。

Objective To compare the clinical effects of percutaneous transforaminal endoscopy with different needle insertion techniques in the treatment of patients with lumbar disc herniation.Methods A total of 90 patients with lumbar disc herniation who underwent percutaneous transforaminal endoscopic surgery in our hospital from January 2019 to January 2022 were selected and randomly divided into two groups,with 45 cases in each group.The control group received conventional posterior approach for needle insertion,and the observation group received 45° posterior approach for needle insertion.The clinical efficacy,pain degree and lower limb function were compared between the two groups.Results No significant difference was found in the excellent and good rate of treatment between the two groups(P >0.05).The VAS scores at 6 months and 1 year after surgery of the observation group were significantly lower than those of the control group(P <0.05).The ODI score at 1 year after surgery of the observation group was significantly lower than that of the control group(P <0.05).Conclusions The short-term curative effects of percutaneous transforaminal endoscopic surgery through conventional posterior approach and 45° posterior approach for needle insertion in the treatment of lumbar disc herniation are comparable,but 45° posterior approach for needle insertion can significantly reduce the long-term postoperative pain and improve the lower limb function of patients.