椎间孔镜髓核摘除术治疗腰椎间盘突出症合并神经根管狭窄的疗效

Treatment of lumbar disc herniation combined with nerve root canal stenosis by foraminal endoscopic extraction of nucleus pulposus

目的分析椎间孔镜髓核摘除术治疗腰椎间盘突出症合并神经根管狭窄的疗效。方法回顾性分析2022年3月至2024年3月行手术治疗的62例腰椎间盘突出症合并神经根管狭窄患者,根据手术方式的不同分为研究组(椎间孔镜髓核摘除术)和对照组(椎板切开髓核摘除椎间植骨融合内固定术),对比两组的临床疗效、腰椎曲度、腰骶角角度、腰椎功能恢复疼痛评分以及并发症发生情况。结果研究组和对照组的优良率分别为93.55%和74.19%,研究组的优良率明显高于对照组(P<0.05);两组术前的腰椎曲度和腰骶角角度相比并差异无统计学意义(P>0.05),两组术后的腰椎曲度均高于术前,且研究组高于对照组(P<0.05),两组术后的腰骶角角度均低于术前,且研究组低于对照组(P<0.05);两组术前的腰椎功能和疼痛评分相比并差异无统计学意义(P>0.05),两组术后的腰椎功能和疼痛评分均低于术前,且研究组低于对照组(P<0.05);研究组的并发症发生率为3.23%,显著低于对照组的19.35%(P<0.05)。结论椎间孔镜髓核摘除术治疗腰椎间盘突出症合并神经根管狭窄的疗效确切,可以有效提高临床疗效,改善患者的腰椎曲度、腰骶角角度和腰椎功能,且有利于减轻患者术后的疼痛,降低并发症发生率。

Objective To analyze the effect of intervertebral endoscopic extraction of nucleus pulposus on lumbar disc herniation complicated with nerve root canal stenosis.Methods A total of 62 patients with lumbar disc herniation complicated with nerve root canal stenosis who underwent surgical treatment from March 2022 to March 2024 were retrospectively analyzed.According to the different surgical methods,they were divided into the study group(transforaminal endoscopic discectomy)and the control group(laminectomy,discectomy,interbody fusion and internal fixation).The clinical efficacy,lumbar curvature,lumbosacral angle,lumbar function recovery pain score and complications of the two groups were compared.Results The excellent and excellent rate of study group and control group were 93.55%and 74.19%,respectively,and the excellent and excellent rate of study group was significantly higher than that of control group(P<0.05).There was no significant difference between the two groups in lumbar curvature and lumbosacral Angle before surgery(P>0.05).The lumbar curvature after surgery was higher than before surgery,and the study group was higher than the control group(P<0.05).The lumbosacral Angle after surgery was lower than before surgery,and the study group was lower than the control group(P<0.05).There were no significant differences in lumbar function and pain scores between the two groups before surgery(P>0.05).The lumbar function and pain scores after surgery were lower than before surgery,and the study group was lower than the control group(P<0.05).The complication rate of the study group was 3.23%,which was significantly lower than that of the control group(19.35%,P<0.05).Conclusion Foraminoscopic extraction of nucleus pulposus is effective in the treatment of lumbar disc herniation combined with nerve root canal stenosis,which can effectively improve clinical efficacy,improve the lumbar curvature,lumbosacral Angle and lumbar function of patients,and is conducive to reducing postoperative pain and reducing the incidence of complications.