经皮三靶点椎间孔成形术治疗腰椎间盘突出症的临床效果及意义

CLINICAL EFFECT AND SIGNIFICANCE OF THREE TARGETS FOR PERCUTANEOUS TRANSFORAMINAL ENDOSCOPIC DISCECTOMY IN THE TREATMENT OF LUMBAR DISC HERNIATION

目的：探讨经皮三靶点椎间孔成形术治疗腰椎间盘突出症的安全性和有效性。方法：选择2013年1月~2014年2月收治的腰椎间盘突出症患者125例,均采用经皮三靶点椎间孔成形术。采用目测视觉模拟评分法（visual analogue scale,VAS）、Oswestry功能障碍指数（oswestry disability indox,ODI）、Macnab标准及红外热成像评定疗效。结果：125例患者平均随访16个月,术前腿痛VAS评分与术后比较明显下降,有显著性差异（P〈0.05）;术前ODI与术前比较明显下降,有显著性差异（P〈0.05）;根据Macnab标准：优98例,良21例,中6例,差0例,优良率95.2%;红外热像采集双下肢皮肤的温差术前与术后比较明显下降,有显著性差异（P〈0.05）。结论：经皮三靶点椎间孔成形术是治疗腰椎间盘突出症安全和有效的微创手术,且三靶点椎间孔成形术可缩短脊柱内镜技术的学习曲线。

Objective： To determine the safety and efficacy of three targets for percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation. Methods： A retrospective review was performed on 125 patients with lumbar disc herniation between January 2013 and February 2014. All the patients received three targets for percutaneous transforaminal endoscopic discectomy. The postoperative neurological function and pain status were evaluated by the visual analogue scale（VAS）, the Oswestry disability index（ODI） and infrared thermal imaging. The patient satisfaction was evaluated by the Macnab criteria. Results： The mean follow-up period was 16 months. The mean preoperative VAS decreased to postoperative at final follow-up respectively. The mean ODI decreased to postoperative at final follow-up, which showed statistical significance（P〈0.05）. The excellent and good outcomes were 95.2%. The infrared thermal imaging pointed out that the leg skin temperature of D-value was a significant improvement compared with pre-operation（P〈0.05）. Conclusion： Three targets for percutaneous transforaminal endoscopic discectomy provides a safe and very effective alternative for lumbar disc herniation, and can decrease the learning curve.