经皮椎间孔镜靶向穿刺技术治疗单节段腰椎间盘突出症的体会

Application of targeted puncture technique in percutaneous transforaminal endoscopic discectomy for the single segment of the lumbar disc herniation

目的探讨经皮椎间孔镜靶向穿刺技术治疗单节段腰椎间盘突出症的临床疗效。方法选择2014年5月~2016年6月在泰州市中医院行经皮椎间孔镜治疗的单节段腰椎间盘突出症患者70例,根据术前、术后1天、术后3个月及末次随访患者VAS评分和ODI指数评价疗效。改良Macnab疗效评定标准评价临床疗效。结果术后VAS和ODI评分均较术前降低,术后1天、术后3个月及末次随访与术前相比较,差异均具有统计学意义(P<0.05),末次随访时根据MacNab标准评分优54例,良10例,可6例,优良率91.4%。结论经皮椎间孔镜靶向穿刺技术治疗单节段腰椎间盘突出症近期疗效满意,是一种安全、有效的微创术式。

Objective To investigate the clinical efficacy of targeted puncture technique in percutaneous transforaminal endoscopic discectomy(PTED)for the single segment oflumbar disc herniation.Methods70patients with the single segment of lumbar disc herniation from May2014to Jun2016in Department of Orthopedics of Taizhou Hospital of Traditional Chinese Medicinewere selected andtreated with PTED.Visual analogue scale(VAS)score,Oswestry disability index(ODI)and modified MacNab criteria were recorded respectively before operation and one day post-operation,3monthspost-operation and last follow-up after operation to evaluate curative effect.Results The VAS and ODI scores after the operation were reduced significantly(P<0.05)compare to the pre-operation scores,evaluation of modified MacNab effects at latest follow-up were as follows:54cases were rated as excellent,10cases were good,6cases were fair,0case was poor,the excellent and good rate was91.4%.Conclusion The targeted puncture technique percutaneous trans-foraminal endoscopic discectomy is a safe effective and minimallyinvasivesurgical technology for the single segment of lumbar disc herniation,which hasa satisfying short-term curative effect.