经皮内镜下腰椎间盘切除术治疗极外侧型腰椎间盘突出症

Treatment of far lateral lumbar disc herniation with percutaneous endoscopic lumbar discectomy

目的评价经皮内镜下腰椎间盘切除术(PELD)治疗极外侧型腰椎间盘突出症(FLLDH)的可行性和有效性。方法2014年7月至2015年8月采用PELD治疗FLLDH患者10例,其中椎间孔内型7例,椎间孔外型3例。于术前、术后1d、术后1个月及末次随访时进行视觉模拟评分(VAS)及日本骨科协会(JOA)评分,末次随访时按改良Macnab标准评价临床疗效。结果患者术后1d、1个月及末次随访时的VAS及JOA评分分别与术前比较,差异均有统计学意义(均P<0.01)。改良Macnab标准评价临床效果,其中优4例,良4例,可2例。10例患者末次随访时症状均无复发。结论 PELD治疗FLLDH可获得良好的近期效果,且安全、微创。

Objective To evaluate the feasibility and efficacy of treatment for far lateral lumbar disc herniation（FLLDH） with percutaneous endoscopic lumbar discectomy （PELD）. Methods From July 2014 to August 2015,10 FLLDH patients were treated with PELD. There were 7 cases of intraforaminal disc herniation,3 cases of extraforaminal disc herniation. When preoperation, 1 day after operation, 1 month after operation and last fol ow- up, the patients were had visual analogue scale （VAS） score and Japanese Orthopaedic Association （JOA） score, according to the modified Macnab criteria to evaluate the clinical efficacy of final fol ow- up. Results The VAS scores and JOA scores of patients between preoperation and after operation were repectively, The differences were statistical y significant （al P〈0.01）. The clinical outcomes were determined using a modified Macnab criteria , which revealed that 4 patients had excel ent result,4 had good,2 had fair. When the last fol ow- up 10 patients had no recurrence of symptoms. Conclusion PELD could achieve satisfactory short- term clinical results in treating FLLDH and is a safe and efficacious minimal y invasive surgical technique.