椎间孔镜可视下动力磨钻系统在椎间孔成形术中的作用

Application of power drill equipment in the visualized foraminoplasty of transforaminal endoscopic spinal surgery

目的评价动力磨钻系统在椎间孔镜可视下行椎间孔成形术中的作用。方法收集2016年1—12月收治的32例腰椎间盘突出症患者资料，椎间孔镜下使用动力磨钻系统行可视下椎间孔成形术及髓核摘除术治疗。比较患者术前术后疼痛视觉模拟评分（visualanaloguescale，VAS）、Oswest~功能障碍指数（Oswest^disabili—tyindex，ODI）和腰椎日本骨科学会评分（JapaneseOrthopaedicAssociation，JOA）的差异，并进行统计学分析。结果所有患者均获得随访，随访时间为3个月。全部患者手术时间为60～120min，平均95．3min。住院天数为5—13天。平均8．3天。患者术中透视次数为10～18次，平均13．5次。患者术前VAS评分较高，在术后3天、2周和3个月时VAS评分降低，与术前相比差异有统计学意义（P〈0．05）。患者术前腰椎功能（ODI和JOA）评分较差，在术后3天得到改善，并在术后3个月得到维持，与术前相比差异有统计学意义（P〈0．05）。结论应用动力磨钻系统在椎间孔镜可视下行椎间孔成形术，较传统磨钻减少了术中透视次数，避免过多切除上关节突，降低了损伤神经的风险，效果满意。

Objective To evaluate the safety and efficacy of power drill equipment in the visuMizcd foraminoplasty of transforaminal endoscopic spinal surgery. Methods Data were collected from 32 luw..b,r disc herniationpatients who were admitted from January to December 2016 to undergo visualized foramiuopiasty and discectomy using power drill e- quipment. The outcomes were evaluated by the visual analog scale k VAS）, the Oswestry disability index （ODI） and the Japanese Orthopaedic Association （JOA）. Results All patients were followed - up for three months. The average opera- tion time was 95.3 rain （60 - 120 rain）. The average hospitalization staywas 8.3 days （5 -13 days）. The average time of intraoperative fluoroscopy was 13.5 （ 10 - 18 ）. The average VAS was remarkably decreased three days, two weeks and three months after surgery, compared with pre -- operative levels （P 〈 0.05 ）. The average ODI and JOA were markedly improved three days after surgery and sustained three months after surgery, compared with pre - operative levels （P 〈 0.05）. Conclusion The use of power drill equipment in visualized foraminoplasty of transforaminal endoscopic spinal surgery can reduce the risk of neural injury and is safe and effective alternative to treat lumbar disc herniation.