经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症

PERCUTANEOUS TRANSFORAMiNAL ENDOSCOPIC DISCECTOMY(PTED) FOR TREATMENT OF LUMBAR DISC HERNIATION

目的:观察经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的临床疗效,探讨该技术的适应证、入路选择、手术技巧等相关问题。方法:对50例确诊为单间隙、特殊类型(突出物巨大、脱垂、部分钙化、极外侧型)的腰椎间盘突出症患者行经皮椎间孔镜下髓核摘除术。所有患者采用数字评分法(numerical rating scale,NRS)和MacNab标准评估疗效,并分别于术后3个月、6个月进行电话随访。结果:NRS由术前8.65±1.21降至术后3个月的2.01±0.53(P=0.00)和术后6个月的1.86±0.25(P=0.00)。术后3个月与6个月的疗效优良率分别为84.0%和87.5%。术中发生渗血1例、术后足下垂1例,均经积极对症处理获满意效果。结论:在严格适应证、选择最佳入路和精细操作的前提下,经皮椎间孔镜下髓核摘除术是治疗某些常用微创技术难以奏效的腰椎间盘突出症的有效方法。

Objective： To explore effects and operative techniques of percutaneous transforaminal endoscopic discectomy（PTED） for treatment of lumbar disc herniation.Methods： 50 cases were involved in the study.The clinical outcome of PTED were evaluated by numerical rating scales（NRS） and MacNab standard.Results： All of the 50 patients were followed-up at 3 months and 32 cases at 6 months.The mean of NRS were declined from 8.65 ± 1.21 to 2.01 ± 0.53（at 3 months） and 1.86 ± 0.25（at 6 months）.There were 84.0%（at 3 months） and 87.5%（at 6 months） of cases whose outcomes were excellent and good.Conclusions： Under the condition of carefully and precisely performance,clinical effects of PTED for treatment of lumbar disc herniation are satisfactory.