基于骨锉系统的椎间孔成形术在腰椎内镜手术中的应用

FORAMINOPLASTY BASED ON BONE FILE SYSTEM IN PERCUTANEOUS ENDOSCOPIC LUMBAR DISCECTOMY

目的:评估一种基于骨锉系统的椎间孔成形技术在经皮腰椎内镜手术中的安全性及有效性。方法:106例腰椎间盘突出症患者接受基于骨锉系统椎间孔成形技术的经皮腰椎内镜手术,手术技术采用THESSYS(thomas hoogland endoscopic spinal system)技术,以下肢痛视觉模拟评分(visual analogue scale,VAS)、患者自评手术满意度、再次接受同类手术意愿、手术时间、有效透视次数、操作相关并发症来评价其有效性及安全性。结果:患者术前下肢痛VAS评分6.7±2.2分,术后6小时下肢痛VAS评分1.1±0.8分,较术前有显著改善(P<0.05)。并发症发生情况有出口根损伤1例,术后24 h内即刻复发1例,并发症发生率1.9%。术后出院前患者自评手术满意度满意者84.9%(90/106),较满意者13.2%(14/106),一般者0.9%(1/106),不满意者0.9%(1/106)。术后1月门诊复查问询再次接受同类手术意愿者98.1%(104/106)。结论:基于骨锉系统的椎间孔成型技术应用于经皮腰椎内镜手术具有良好的安全性及临床疗效。

Objective： To assess a novel method of foraminoplasty based on bone file system in Percutaneous Endoscopic Lumbar Discectomy （PELD）. Methods： One hundred and six patients with lumbar disc herniation received PELD in our department received the surgical technic based on a new bone file system and Thomas Hoogland Endoscopic Spinal System （THESSYS）. VAS score of leg pain, Patients＇ self-reported satisfaction, reoperation intention, operation time, fluoroscopy time and operation related complications were used to assess safety and effectiveness. Results： The preoperative VAS score of leg pain was 6.7±2.2 and the 6 hours postoperative VAS score of leg pain was 1.1 ± 0.8, which means that patients＇ leg pain was significantly reduced 6 hours after surgery. 2 cases of complications were encountered, including 1 case of exit nerve root injury, 1 case of pain recurrence in 24 hours. Patients＇ self-reported satisfaction included 84.9% of excellent （90/106）, 13.2% of good （14/106）, 0.9% of acceptable （1/106） and 0.9% of unsatisfactory （1/106）. The reoperation intention one month after surgery was 98.1% （104/106）. Conclusion： Foraminoplasty based on bone file system is a safe and effective method in Percutaneous Endoscopic Lumbar Discectomy.