经皮内镜椎板间入路微创治疗青少年腰椎间盘突出症

Percutaneous endoscopic interlaminar discectomy on lumbar disc herniation in adolescents

目的探讨经皮内镜椎板间入路微创治疗青少年腰椎间盘突出症的适应证、手术技巧及临床疗效。方法2010年1月至2012年1月采用经皮内镜椎板间入路微创治疗青少年腰椎间盘突出症患者25例，其中男19例，女6例，年龄13-18岁。记录患者病史、体征、影像学检查结果，采用Oswestry残障指数（oswestry disability index，ODI）、疼痛视觉模拟评分（visual analogue scale，VAS）、Nakai分级评定临床疗效。结果25例患者均获得随访，平均随访19．7个月（13～26个月）。术后随访患者ODI、VAS评分均较术前有明显下降，差异有统计学意义（P〈0．01）。根据Nakai分级：优17例，良6例，中2例，优良率92％。结论经皮内镜椎板间入路椎间盘切除术具有创伤小、患者恢复快、疗效确切等优点，是治疗中央型和旁中央型青少年腰椎间盘突出症安全、有效的方法。

Objective To evaluate the indications, surgical techniques and clinical outcomes ofpercutaneous endoscopic interlaminar discectomy （ PEID ） in treating adolescent lumbar disc herniation. Methods 25 consecutive adolescent patients with lumbar disc herniation were treated by PEID from January 2010 to January 2012. Among them, 19 were male and 5 were female. The age ranged from 13 to 18 years. Oswestry Disability Index （ ODI ）, Visual Analogue Scale （ VAS ） and the Nakal standard were used to evaluate the patients＇ outcomes preoperatively and during the follow-up. Results All patients were followed up. The mean time of the follow-up was 19.7 months （ range; 13-26 months ）. The ODI and VAS significantly decreased postoperatively comparing with that preoperatively, and the differences were statistically significant （ P〈0.01 ）. According to Nakai standard, the clinical effects were excellent in 17 cases, good in 6 cases and fair in 2 cases. The excellent and good rate was 92%. Conclusions PEID has advantages of minimal traumatization and scar formation, quick recovery and well effects. Patients under PEID get immediate pain relief. PEID is a safe minimally invasive surgical procedure in treating adolescent lumbar disc herniation.