经皮椎间孔镜微创手术治疗腰椎间盘突出症的临床疗效分析

Analysis of clinical curative effect of percutaneous endoscopic lumbar discectomy on lumbar disc herniation

目的探讨经皮椎间孔镜技术治疗腰椎间盘突出症(LDH)的临床疗效。方法选择2014年7月~2015年7月应用局麻下经皮椎间孔椎间盘摘除术(PELD)治疗64例腰椎间盘突出症患者为研究对象,所有患者均为单节段腰椎间盘突出症者,平均病程19.6个月。采用腰腿痛视觉模拟评分(VAS)、JOA评分、ODI功能障碍指数评分评价患者疼痛及腰椎功能改善情况,改良MacNab标准评定疗效。结果术后VAS、ODI评分较术前明显降低(P<0.01),术后JOA评分较术前明显增高(P<0.01)。术后12个月时用改良MacNab标准评定疗效,优44例,良16例,可4例,优良率93.8%。结论应用PELD治疗腰椎间盘突出症近中期疗效肯定,随着恢复时间延长,腰椎功能逐渐改善。

Objective To investigate therapeutic effect of percutaneous endoscopic lumbar discectomy on lumbar disc herniation. Methods From July 2014 to July 2015, 64 patients suffered from lumbar disc herniation and underwent percutaneous endoscopic lumbar discectomy under local anesthesia were retrospectively reviewed. There were 34 males and 30 females，with an average age of 50.2 years. The mean course of disease was 19.6 months. All patients had single level involved. The pain and daily activity was evaluated by the visual analog score（VAS）, Japanese Orthopaedic Association（JOA）Scores and the Oswestry disability index （ODI）, respectively. Modified MacNab criteria were employed to measure the clinical results.Results In the postoperative each groups, VAS of back and leg pain and ODI scores were significantly lower（P＜0.01） and JOA score observably higher than the preoperative （P＜0.01）. At 12 months after operation based on the modified MacNab criteria, the results were excellent in 44 cases, good in 16 cases, fair in 4 cases. The excellent and good rate was 938%.Conclusion The near and medium term efficacy of PELD for lumbar disc herniation is positive with the recovery time and lumbar function and gradually improved.