经皮椎间孔镜下治疗腰4/5椎间盘突出症的临床研究

The clinical research about percutaneous endoscopic treatment of lumbar intervertebral foramen 4/5 disc herniation

目的探讨经皮椎间孔镜(PTED)和传统开窗手术在腰4/5椎间盘切除术中的临床疗效比较。方法该院2012年1月至2014年1月收治的60例术前确诊为腰4/5椎间盘突出症患者,随机分为PTED组和传统开窗手术组,各30例。比较2组患者手术前后ODI与VAS评分,优良率及围术期各项临床指标。结果 PTED组患者的围术期各项临床指标优于传统开窗术组,差异有统计学意义(P<0.05)。按照改良的MacNab法评定优良率分别为88%和91%,2组差异无统计学意义(P>0.05)。PTED组和传统开窗手术组术后ODI、VAS与术前比较,差异有统计学意义(P<0.05)。结论 PTED具有切口小、出血少、创伤小和术后恢复快等微创优势,是一种安全有效的手术方法。

Objective To compare the percutaneous transforaminal mirror（percutaneous transforaminal endoscopic discectomy,PTED）to traditional fenestration at L4/5disc resection in clinical efficacyMethods 60 patients with lumbar 4/5disc herniation in the hospital from January 2012 to January 2014 were randomly divided into two groups：traditional fenestration（30cases）and PTED group（30cases）.Comparison of the two groups of patients before and after surgery ODI and VAS scores,excellent rate and perioperative clinical parameters.Results Perioperative various clinical indicators PTED group of patients than the traditional fenestration group,a statistically significant difference（P〈0.05）.Assessed according to the modified MacNab method excellent rate was 88%and 91%,respectively,there was no significant difference（P〉0.05）.PTED groups and traditional fenestration postoperative ODI,VAS compared with preoperative,were significantly improved（P〈0.05）.Conclusion PTED and traditional surgical fenestration two short-term results in the treatment of lumbar disc herniation were satisfied.In the case of strictly selected indications for surgery,PTED with a small incision,less bleeding,less trauma and faster recovery after surgery and other minimally invasive advantages,is a safe and effective minimally invasive surgical techniques,and compared to traditional open surgery efficacy no significant difference.