脊柱微创术治疗症状性椎体血管瘤合并腰椎间盘突出症

Minimally invasive surgeries for symptomatic vertebral hemangioma accompanied with lumbar disc herniation

[目的]观察微创治疗症状性椎体血管瘤合并腰椎间盘突出症的疗效。[方法] 2016年1月～2017年1月,本科采用同期椎体成形术和椎间孔镜髓核摘除术技术治疗症状性椎体血管瘤合并腰椎间盘突出症28例。患者均经临床体征及影像学资料确诊,其中男18例,女10例;年龄48～68岁,平均(53.23±11.47)岁。采用JOA、VAS及Oswestry评分评价临床效果。[结果]术后28例腰腿痛症状均得到明显缓解或消失。JOA评分由术前(20.10±4.20)分增加至术后12个月的(28.10±2.00)分,差异有统计学意义(P<0.05),VAS评分由术前(7.50±1.20)分减少至术后12个月的(1.60±0.50)分,差异有统计学意义(P<0.05),Oswestry评分由术前(18.30±11.20)减少至术后12个月的(7.20±6.30)分,差异有统计学意义(P<0.05)。[结论]运用脊柱微创技术治疗症状性椎体血管瘤合并腰椎间盘突出症是一种有效并安全的方法,手术要点在于准确穿刺定位及镜下熟练操作。

[Objective] To observe the clinical outcomes of minimally invasive surgeries for symptomatic vertebral hemangioma complicated with lumbar disc herniation. [Methods] From January 2016 to January 2017, 28 patients with symptomatic vertebral hemangioma accompanied with lumbar disc herniation were treated with percutaneous vertebroplasty（PVP） and percutaneous transforaminal endoscopic discectomy（PTED） simultaneously in our department. The patients were definitively diagnosed by clinical and imaging examinations, including 18 males and 10 females aged from 48 to 68 years with an average age of 53 years. The JOA score, visual analogue scale（VAS） for pain and Oswestry score were applied for assessment of clinical consequences. [Results] The symptoms of lumbago and leg pain were obviously relieved or disappeared in all the 28 patients after operation. The JOA significantly increased from（20.10±4.20） preoperatively to（28.10±2.00） at 12 months after operation（P〈0.05）, whereas the VAS significantly decreased from（7.50±1.20） before operation to（1.60±0.50） at 12 months postoperatively（P〈0.05）, and Oswestry score significantly declined from（18.30±11.20） preoperatively to（7.20±6.30） at the latest follow up（P〈0.05）. [Conclusion] The concurrent PVP and PTED are an effective and safe technique for the treatment of symptomatic vertebral hemangioma accompanied with lumbar intervertebral disc herniation, and the key points in surgery are of accurate puncture location and skillful operation under the endoscope.