经皮椎间孔镜治疗合并退变性侧弯、后凸畸形的单节段腰椎间盘突出症

Percutaneous endoscopic lumbar discectomy （PELD） for patients with single segment lumbar disc herniation complicated with degenerative lateral curvature and kyphosis

目的评价经皮椎间孔镜微创治疗退变性侧弯、后凸畸形合并单节段腰椎间盘突出症的短期疗效。方法选择采取腰椎椎间孔镜手术治疗的22例退变性侧弯、后凸畸形合并单节段腰椎间盘突出症患者，所有患者均有不同程度腰背部及单侧下肢神经根性放射痛。对22例患者的临床资料进行回顾性分析，平均随访18个月。分别在术前、术后第1个月，3个月及18个月时间点，采用腰椎JOA和Oswestry功能障碍指数（ODI）问卷调查评分评定；并在终末随访时根据MacNab评定标准，评价其手术短期疗效。结果患者腿痛JOA评分及ODI指数，术前术后比较差异有统计学意义（P〈0.05）；根据MacNab评定标准：优11例（50%），良8例（36.4%），中2例（9%），差1例（4.5%），优良率为86.4%。结论经皮椎间孔镜手术技术，能有效减轻患者腿部疼痛症状，达到满意效果，是治疗退变性侧弯、后凸畸形合并单节段腰椎间盘突出症微创方式，值得推广。

Objective To evaluate the short-term effect of percutaneous endoscopic lumbar discectomy（PELD） on patients with single segment lumbar disc herniation complicated with degenerative lateral curvature and kyphosis.MethodsTwenty-two patients with single segment lumbar disc herniation complicated with degenerative lateral curvature and kyphosis were selected, all of the patients had different degrees of lumbar and unilateral lower limb nerve root radiation pain. The data of the 22 patients were analyzed retrospectively, the mean follow-up was 18 months. The effect was evaluated before operation, one month, 3 months and 18 months after operation, according to the lumbar spine JOA and Oswestry dysfunction index （ODI）. At the end of the follow-up period, according to the MacNab evaluation criteria, the short-term effect of the operation was evaluated.ResultsThere was significant differences in the Leg pain JOA score and ODI index of the patients before and after operation（P〈0.05）. According to the MacNab evaluation criteria： there were excellent in 11 cases （50%）, good in 8 cases （36.4%）, medium in 2 cases（9%）, poor in 1 case （4.5%）, the excellent and good rate was 86.4%.ConclusionsPercutaneous endoscopic lumbar discectomy can effectively reduce the leg pain symptoms of patients, and achieve satisfactory results. It is the minimal treatment of patients with single segment lumbar disc herniation complicated with degenerative lateral curvature and kyphosis, and it is worthy of promotion.