经皮穿刺椎间孔镜治疗老年腰椎间盘突出症的疗效

Effect of Percutaneous Transforaminal Endoscopic Discectomy in Surgical Treatment of Lumbar Intervertebral Disc Herniation in the Elderly

目的探讨经皮穿刺椎间孔镜手术治疗老年腰椎间盘突出症患者的疗效。方法 77例椎间盘突出患者根据年龄分为两组,60~80岁的为老年组(n=34),小于60岁的为中青年组(n=33),两组患者均接受经皮穿刺椎间孔镜手术治疗,随访并对比两组患者NRS评分,ODI评分及JOA评分以评价疗效。结果两组患者术后NRS评分、ODI评分在各时间点较术前均有降低(P<0.01),术后1月内,老年组患者NRS评分较中青年组高(P<0.05),术后3月及6月,两组NRS评分相当(P>0.05)。术后6月内,老年组ODI评分均高于中青年组(P<0.05)。术后1月时老年组改善率较中青年组差,两组术后3月与6月的改善率相当。结论椎间孔镜手术对改善腰椎间盘突出症患者的疼痛及腰腿功能障碍有效,而老年患者改善较慢。

Objective To explore the curative effect of percutaneous transforaminal endoscopic discectomy(PTED)in the surgical treatment of lumbar intervertebral disc herniation in the elderly. Methods 67 patients with intervertebral disc herniation were divided into 2 groups according to their age: elderly group(aged from 60 to 80, n=34) and young group(age<60,n=33); all the patients in both groups received PTED and were followed up; a comparative study of NRS scores, ODI scores and JOA scores of the patients was made between the 2 groups and the curative effect was evaluated. Results The NRS score and ODI score of the patients in both groups at each time point after treatment were lower than those before treatment(P<0.01);1 month after treatment, NRS scores of the patients in elderly group were higher than those in young group(P<0.05) while 3to 6 months after treatment, the NRS scores in the 2 groups were of no significant differnce(P>0.05); within the 6 months after treatment, the ODI score in elderly group kept higher than those in young group(P<0.05); the improvement in elderly group1 month after treatment was poorer than that in young group while the improvement in both group 3 to 6 months after treatment was of no difference. Conclusions PTED is effective in relieving the pain and improving the waist and leg function though the improvement in the elderly is slow..