经皮内窥镜激光椎间盘摘除术治疗腰椎间盘突出症的近期疗效

Percutaneous endoscopic laser discectomy in the treatment of lumbar disc herniation:short-term outcomes

[目的]探讨经皮内窥镜激光椎间盘摘除术对腰椎间盘突出症的近期治疗效果。[方法]2008年7月～2009年1月,36名腰椎间盘突出症患者在本院接受利用结合侧方发射激光和Ellman高频射频装备的经皮内窥镜椎间盘摘除术,疗效判断采用了术前及术后腰痛及腿痛视觉模拟评分(VAS)的变化情况,术后1年时MacNab功能评分。[结果]全部手术均顺利完成,手术时间为30～70min,平均42min,无术中并发症发生,手术成功率为97%,手术复发率为3%。所有患者最终随访时间均为1年,腰痛VAS评分术前6.19分,术后1年2.25分;腿痛VAS评分术前8.25分,术后1年1.75分;术后腰痛和腿痛的VAS评分较术前均明显降低(P<0.01)。按照MacNab评分标准,术后1年随访时,优28例,良6例,优良率94%。[结论]经皮内窥镜激光椎间盘摘除术治疗腰椎间盘突出症创伤小、安全,而且近期疗效好。

[ Objective] To investigate the short- term therapeutic effect of percutaneous endoscopic laser discectomy in the treatment of lumbar disc herniation. [ Methods ] Between July 2008 and January 2009, 36 patients with lumbar disc herniation underwent percutaneous endoscopic discectomy combined with side - firing laser and Ellman high - frequency radiosurgical device in our department, clinical outcomes were reviewed in terms of pain visual analogue scale （VAS） and MacNab criteria. [ Results ] All the procedures were performed successfully with operative time 30 -70 min （average 42 min） . There was no intraoperative complication, the success rate of surgery was 97%, and the recmTence rate was 3%. The last follow- up was performed one year after the surgery. VAS score of low back pain decreased from 6. 19 before operation to 2. 25 one year after operation. VAS score of leg pain decreased from 8.25 to 1. 75 one year after operation. There were significant differences between preoperative VAS scores and postoperative VAS scores in the low back pain and leg pain （ P 〈 0. 01 ） . According to MacNab criteria, there were 28 excellent and 6 good results, with the total response rate of 94%. [ Conclusion ] Percutaneous endoscopic laser discectomy is a less invasive but safer surgical procedure. It can provide satisfactory short - term outcomes for patients with lumbar disc herniation.