经皮椎间孔镜微创技术治疗腰椎间盘突出症的临床疗效观察

Efficacy observation of percutaneous transforaminal endoscopic discectomy in protrusion of lumbar intervertebral disc

目的观察腰椎间盘突出症临床予以经皮椎间孔镜微创手术治疗的效果。方法选取52例腰椎间盘突出症患者,根据临床术式不同分为两组,对照组24例行后路椎间融合、椎弓根螺钉内固定治疗,研究组28例行经皮椎间孔脊柱内窥镜下腰椎间盘切除术(PTED)治疗,对比两种术式腰椎间盘突出治疗效果,比较治疗前后腰椎功能、疼痛改善情况。结果研究组治疗总有效率为96.4%,对照组为87.5%,差异有统计学意义(P<0.05);治疗前患者疼痛、腰部功能评分组间比较差异无统计学意义,治疗后研究组VAS、ODI评分均低于对照组(P<0.05)。结论临床对腰椎间盘突出症者行PTED治疗,术后患者疼痛、腰部功能障碍得到明显改善,临床治疗效果好,可临床推广应用。

Objective To observe the effectiveness of percutaneous transforaminal endoscopic discectomy（PTED） in protrusion of lumbar intervertebral disc. Methods 52 patients with protrusion of lumbar intervertebral disc were assigned to control group（n=24） and study group（n=28） according to different surgical modes. Patients took the posterior lumbar interbody infusion plus internal fixation with pedicle screw or PTED, respectively. The therapeutic effect, lumbar-vertebral function and pain relief was compared. Results The total effective rate in the study group was significantly higher than control group（96.4% vs 87.5%）（P〈0.05）; before surgery, there were no significant between-group difference in the pain degree and lumbar function scores; after treatment, the VAS（visual analogue scale） and ODI（oswestry dability index） points in the study group were lower than control group（P〈0.05）. Conclusion The PTED can greatly relieve the pain, improve the lumbar function and increase the therapeutic effect. It is worthy of clinical promotion and application.