经皮椎间孔镜TESSYS技术治疗腰椎间盘突出症18例的近期疗效

The efficacy of 18 Patients with Disc Herniation Percutaneous Transforaminal Endoscopic Discectomy for Lumbar TESSYS

目的:评估经皮椎间孔镜(transformationalendoscopespinesystem,TESSYS)技术治疗单节段腰椎间盘突出的近期临床疗效,总结临床经验。方法选择单节段椎间盘突出症患者18例,行侧后路经皮THESSYS椎间孔镜下椎间盘髓核摘除手术,应用疼痛视觉模拟评分(VAS评分)、Oswestry功能障碍(ODI)指数及改良Macnab标准评价其临床疗效。结果术后1d及术后1w、1个月的VAS评分分别为(3.6±0.8)、(3.2±0.7)、(2.5±0.6)分,均显著低于术前的(8.74±1.4)分(P值均<0.01)。术后1d及术后1w、1个月的ODI指数分别为(32.2±8.2)%、(21.3±4.9)%及(18.8±8.3)%,均显著低于术前的(82.2±12.6)%(P值均<0.01)。根据改良Macnab标准评价疗效:优7例,良9例,可2例,差0例。仅1例患者于术后当天出现一过性神经麻痹,未行特殊处理,3d后症状消失。结论应用PTED行髓核摘除术治疗腰椎间盘突出症的近期疗效可靠。

Objective To evaluate the preliminary clinical outcomes of percutaneous transformational endoscope discectomy(PTED)in treating lumbar disc herniation after conservative treatment.Methods Total y 18 patients with single lumbar disc herniation failed in conservative treatment and then received posterolateral(PTED Clinical outcomes were evaluated by visual analogue scale(VAS),Oswestry disability index(ODI)and modified Macnab criteria before and after the operation.Results The postoperative VAS scores(3.6±0.8,3.2±0.7,2.5±0.6 at 1 day,1 week and 1 months)were significantly lower than preoperative one(8.74±1 4,P<0.01)The postoperative ODI(32.2%±8.2%,21.3%±4.9%,18.8%±8.3%at 1 day,1 week,1 months)were also significantly lower than preoperative one(82.2%±12.6%,P<0.01).According to the modified Macnab criteria,the therapeutic outcome was excellent in 7 cases,good in 9,fair in 2,and poor in 0.Transient nerve palsy occurred in one patient on day 1 after operation and disappeared after 3 days without special treatment.Conclusion The preliminary study shows that PTED is safe and ef ective in treating lumbar discherniation.