经皮内镜椎间孔入路术治疗腰间盘突出远期疗效

Long-term Curative Effect of Treatment of Lumbar Disc Herniation by Percutaneous Endoscopic Interlaminar Lumbar Discectomy

目的:研究经皮内镜椎间孔入路微创术治疗腰间盘突出的临床效果。方法:收集因腰间盘突出就诊的患者86例,依据随机数字表法分为采用经皮内镜椎间孔入路微创术治疗组48例(研究组),开放手术治疗组38例(对照组),比较两组手术时间、出血量、住院时间和术后腰腿痛VAS评分;比较手术前后腰椎神经情况以及Man Nab优良率。结果:研究组的手术时间(61.8±18.9)min显著低于对照组(79.9±20.3)min,出血量(22.0±7.9)m L和住院时间(8.6±1.0)d少于对照组的(58.9±14.7)m L、(18.0±1.3)d;研究组术后6个月及末次随访VAS评分为(2.85±0.62)分、(0.84±0.07)分,显著低于对照组[(3.26±0.89)分、(1.52±0.26)分];研究组术后6个月以及末次随访JOA评分为(20.81±2.77)分、(26.71±3.91)分,显著高于对照组[(18.62±2.14)分、(21.87±2.87)分],术后6个月以及末次随访ODI评分为(13.69±3.21)分、(10.96±1.34)分,显著低于对照组的(15.83±3.37)分、(12.86±2.07)分(均P<0.05)。两组优良率差异无统计学意义(P>0.05)。结论:经皮内镜椎间孔入路微创术治疗腰间盘突出,能达到和开放手术一致的效果,而且术中创伤小,术后恢复快。

Objective To observe the clinical effect of percutaneous endoscopic interlaminar lumbar discectomy in the treatment of lumbar disc herniation.Methods A total of 86 patients treated for lumbar disc herniation were collected.According to the random number table method,patients were divided into study group(48 cases)and control group(38 cases).Patients in the study group were treated with percutaneous endoscopic interlaminar lumbar discectomy and patients in the control group were treated with open surgery.The operative time,blood loss,length of hospital stay and VAS scores of postoperative lumbar and leg pains were compared between the two groups.The lumbar nerve condition and excellent rate of Man Nab before and after surgery were also compared.Results The operative time[(61.8±18.9)min]in the study group was significantly lower than that in the control group[(79.9±20.3)min](P<0.05).The blood loss[(22.0±7.9)mL]and the length of hospital stay[(8.6±1.0)d]in the study group were less than those[(58.9±14.7)mL]and(18.0±1.3)d in the control group(P<0.05).The VAS scores of the study group at the 6th month and the last follow-up were(2.85±0.62)and(0.84±0.07),which were significantly lower than those of the control group[(3.26±0.89)and(1.52±0.26)](P<0.05).The JOA scores of the study group at the 6th month and the last follow-up were(20.81±2.77)and(26.71±3.91),which were significantly higher than those of the control group[(18.62±2.14)and(21.87±2.87)](P<0.05).The ODI scores of the study group at the 6th month and the last follow-up were(13.69±3.21)and(10.96±1.34),which were significantly lower than those of the control group[(15.83±3.37)and(12.86±2.07)](P<0.05).There was no significant difference in excellent and good rate between the two groups(P>0.05).Conclusion The percutaneous endoscopic interlaminar lumbar discectomy in treatment of lumbar disc herniation could achieve the same results as open surgery.Furthermore,it also has less intraoperative trauma and rapid postoperative recovery.