经皮椎间孔镜治疗伴有钙化型腰椎间盘突出症的中远期效果分析

Efficacy analysis of medium and long term of percutaneous transforaminal endoscopic discectomy in the treatment of calcified lumbar disc herniation

目的探讨经皮椎间孔镜髓核摘除术(PTED)治疗钙化型腰椎间盘突出症(CLDH)的中远期效果。方法选取2012年9月~2015年9月我院收治的35例CLDH患者作为研究对象,根据治疗方法不同分为常规组(18例)和孔镜组(17例),分别给予传统椎板开窗髓核摘除术及PTED治疗,比较两组的中远期效果。结果孔镜组的切口长度、术后卧床时间及住院天数均显著短于常规组,术中出血量少于常规组,差异有统计学意义(P<0.05)。孔镜组术后6个月、1年时的VAS评分及ODI指数均显著低于常规组,差异有统计学意义(P<0.05)。两组的Mac Nab优良率比较,差异无统计学意义(P>0.05)。结论对于CLDH,PTED与传统开窗术治疗具有相似的中远期效果,而PTED创伤小、术后恢复快,值得推荐。

Objective To explore the medium and long term efficacy of percutaneous transforaminal endoscopic discectomy（PTED） in the treatment of calcified lumbar disc herniation（CLDH）.Methods 35 patients with CLDH in our hospital from September 2012 to September 2015 were selected and divided into the routine group（18 cases） and the PTED group（17 cases） according to the different treatment methods,and were treated with traditional open window discectomy and PTED,respectively.The medium and longterm efficacy of the two groups was compared.Results The incision length,postoperative bed time and length of stay of the PTED group was shorter than that of the routine group,the intraoperative bleeding volume of the PTED group was less than that of the routine group,with significant difference（P〈0.05）.The VAS scores and ODI index in the PTED group at 6 months and 1 year after operation was lower than that in the routine group,with significant difference（P〈0.05）.There was no significant difference in the excellent and good rate of Nab Mac between the two groups（P〉0.05）.Conclusion For the treatment of CLDH,PTED and traditional open window discectomy has a similar medium and long term efficacy,and PTED has the advantages of small trauma and fast recovery after surgery,it is worth recommending.