经皮椎间孔镜术治疗青少年腰椎间盘突出症的临床疗效

Clinical efficacy of percutaneous transforaminal endoscopic discectomy in treating adolescent patients with lumbar disc herniation

目的探讨经皮椎间孔镜下椎间盘切除术(PTED)治疗青少年腰椎间盘突出症的临床疗效。方法回顾性分析2012年3月至2016年3月安徽医科大学第二附属医院骨科诊断为单节段单侧腰椎间盘突出症的43例青少年患者的临床资料。记录患者术前、术后3 d、6个月、12个月腰部及下肢视觉疼痛模拟评分(VAS),末次随访采用改良MacNab评价标准进行腰椎功能临床疗效评价。结果 43例患者均获得随访,随访时间12～24个月,平均18. 33个月。背部疼痛VAS评分术前为(5. 3±2. 5)分,术后3 d为(3. 0±1. 3)分,术后6个月为(2. 1±0. 5)分,术后12个月为(2. 0±0. 7)分;下肢疼痛VAS评分术前为(7. 2±2. 7)分,术后3 d为(3. 2±1. 3)分,术后6个月为(2. 1±1. 3)分,术后12个月为(1. 9±0. 8)分,手术前后评分相比差异均有统计学意义(P <0. 01)。根据改良的MacNab标准,26例患者优,14例患者良好,3例患者可,在末次随访时优良率为93. 02%。结论 PTED对于青少年腰椎间盘突出症患者是一种有效且安全的干预措施。

Objective To evaluate the clinical efficacy of percutaneous transforaminal endoscopic discectomy in treating adolescent patients with lumbar disc herniation.Methods The clinical data of43adolescent patients with lumbar disc herniation in the orthopaedics department of the second affiliated hospital of Anhui medical university from March2012to March2016were retrospectively analyzed.The visual analogue scale(VAS)of the lumbar and lower limb pain were recorded at before operation and3days,6months and12months after operation,and the clinical efficacy of the lumbar vertebrae function at the final follow-up was evaluated with the modified MacNab evaluation criteria.Results All the43patients were followed up for12to24months with an average of18.33months.The mean VAS score for back pain were(5.3±2.5)points before surgery,and(3.0±1.3)points,(2.1±0.5)points,and(2.0±0.7)points at3days,6months,and12months after surgery,respectively.The mean VAS scores for lower limb pain were(7.2±2.7)points before surgery,and(3.2±1.3)points,(2.1±1.3)points and(1.9±0.8)points at3days,6months,and12months after surgery,respectively.The scores before and after surgery were significantly different(P<0.01).According to the modified MacNab standard,26patients achieved excellent results,14patients achieved good results,3patients obtained general results,and the excellent and good rate was93.02%at the final follow-up.Conclusion Percutaneous transforaminal endoscopic discectomy is an effective and safe intervention for adolescent patients with lumbar disc herniation.