经皮椎间孔镜下髓核摘除术治疗症状性邻近节段退变的疗效分析

Clinical efficacy of percutaneous transforaminal endoscopic discectomy on symptomatic adjacent segment degeneration after lumbar fusion surgery

目的探究经皮椎间孔镜下髓核摘除术（percutaneous transforaminal endoscopic discectomy,PTED）治疗腰椎融合术后症状性邻近节段退变（adjacent segment degeneration,ASD）的临床疗效。方法选取某院2012年8月至2015年3月收治的22例因腰椎融合术后症状性ASD而行PTED的患者,比较分析22例患者术前、术后第1天、术后3、6、9个月的腰腿痛视觉疼痛模拟评分（visual analogue scale,VAS）、功能障碍指数（oswestry disability index,ODI）以及术后9个月Macanb评分。结果 22例患者均获得随访,随访时间9~18个月,平均14.4月。术后VAS评分以及ODI与术前相比均明显降低,差异有统计学意义（P〈0.05）。按MacNab标准,术后9个月随访时优者10例,良者9例,可者2例,差者1例,优良率81.8%（19/22）。结论 PTED治疗腰椎融合术后症状性ASD短期内疗效显著。

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