国产微创电动椎间盘旋切器的临床应用研究

The clinical application of homemade decompressor for treatment of lumbar disc herniation

目的评价国产微创电动椎间盘旋切器治疗腰椎间盘突出症的疗效及其操作的安全性。方法包容性腰椎间盘突出症25例,在DSA引导下,经后外侧入路行病变椎间盘髓核旋切减压治疗。观察治疗前、后1、3、10 d和3个月的VAS、双下肢直腿抬高试验度数差值、患者满意度,评价疗效及观察并发症。结果术后1 d、3 d、10 d和3个月VAS评分分别为(3.79±1.61)、(2.84±1.57)、(2.89±1.55)、(2.60±1.31)与术前(6.84±1.64)比较明显降低(P<0.01);术后10 d和3个月双下肢直腿抬高试验差值分别为(5.79±7.69)度、(4.76±6.50)度与术前(23.68±5.97)度比较降低明显(P<0.01)。88%(22例)患者对使用旋切治疗满意。疗效评价:痊愈60%(15例),显效20%(5例),有效16%(4例),无效4%(1例);显效率80%(20例),有效率96%(24例);术中、术后未发生任何并发症。结论国产微创电动椎间盘旋切器治疗腰椎间盘突出症近期疗效满意、操作简便、安全。

Objective To assess the clinical efficacy and safety of percutaneous disc decompression with homemade decompressor for treatment of lumbar disc herniation（LDH） . Methods Twenty-five patients diagnosed as contained lumbar disc herniation were decompressed by decompressor through percutaneous posterolateral approach under the guidance of X- ray. The VAS, straightleg raising test（SLRT） were evaluated before treatment and 1 day, 3 days , 10 days and 3 months after treatment and the patient＇s satisfacation was investigated. The complications during manipulation and after therapy were recorded. Results The VAS of 1, 3, 10 days and 3 months after treatment were significantly lower than that before treatment（P d0.01）, the SLRT t0 days and 3 months after treatment was improved obviously （P d0.0l）. No complications were observed. The cure rate, significant, effective and ineffective rates were 60% （15 cases） , 20% （5 cases）, 16% （4 cases） and 4% （1 cases） respectively. The significant improvement rate was 80% （20 cases） and the effective improvement rate was 96% （24 cases）. Patient＇ s satisfication was 88% （22 cases）. Conclusion The earlier curative efficacy is good for the treatment of contained lumbar disc herniation with homemade decompressor, which is safety, simple manipulation and minimal invasion.