经皮椎板间内镜与椎板小开窗术治疗腰椎间盘突出症临床疗效比较

Comparison of the Clinical Efficacy of Percutaneous Endoscopic Lumbar Discectomy between Vertebral Plate and Limited Electric Drill Discectomy in the Treatment of Lumbar Disc Herniation

目的:分析和比较椎板间内镜与椎板小开窗术治疗腰椎间盘突出症的临床疗效和安全性指标。方法:使用回顾性分析的方法对2012-2014年共计126例在我科行椎板间内镜手术或椎板小开窗手术的腰椎间盘突出患者进行分析和比较。通过纳入和排除标准的筛选,经皮椎板间内镜组纳入48例,椎板小开窗组纳入78例。结合详实的术后随访,对两组患者在花费,住院时间等一般性指标,疼痛指标,功能指标,并发症等数据进行分析和比较。结果:两组患者在术后均取得明显的治疗疗效,在疼痛、功能等指标中都有明显的改善。但两组之间并无明显统计学差异(P>0.05)。而椎板间内镜组在住院时间,出血量,切口长度及并发症等方面明显的优于小开窗组,具有统计学意义(P<0.05)。结论:经皮椎板间内镜手术作为一种脊柱微创手术,治疗效果确切,安全性好,能体现微创的优势,可作为椎间孔镜技术在治疗椎间盘突出症的有益补充,在临床中进一步的开展和推广。

Objective： To compare the clinical effect and safety of patients with lumbar disc herniation treated with percutaneous endoscopic lumbar discectomy （percutaneous endoscopic lumbar discectomy, PELD） between vertebral plate or limited electric drill discectomy. Methods： We retrospectively reviewed 126 patients with lumbar disc herniation treated from 2012 to 2014. 48 patients received percutaneous endoscopic lumbar discectomy between vertebral plate and 78 patients were given limited electric drill discectomy （control group）. Clinical outcomes were evaluated by cost, lumbar vertebral function and complications and so on. Results： The VAS score, ODI, and lumbar function of the patients were significantly better than pre-operation, but there was no difference between two groups. The time in hospital, blood loss and length of incision of patients who had PELD was significantly better compared with those who had limited electric drill discectomy （P〈0.05）. Conclusions： PELD between vertebral plate as one minimally invasive surgery has obvious advantages in some aspects of the treatment of lumbar disc herniation, which could be a good supplementary for PELD in clinic.