椎间孔镜与椎板间开窗腰椎间盘切除术疗效对比

Comparison of surgical outcomes between transforaminal endoscopic discectomy and fenestration discectomy

目的探讨椎间孔镜椎间盘切除术(TED)与椎板间开窗椎间盘切除术(FD)治疗单节段腰椎间盘突出症的疗效差异。方法选取2015年1月至2017年12月揭阳市人民医院收治的69例单节段腰椎间盘突出症患者,按随机数字表法分为TED组和FD组,其中TED组36例、FD组33例。对两组切口长度、手术时间、围手术期并发症、住院时间、末次随访日本骨科学会评分(JOA)及视觉模拟量表(VAS)评分进行比较。结果随访时间6~25个月,平均随访时间(18.8±12.5)个月。两组末次随访JOA评分、VAS评分、围手术期并发症比较,差异无统计学意义(P>0.05),但在切口长度、手术时间及住院时间方面,TED组短于FD组(P<0.05)。结论TED和FD治疗单节段腰椎间盘突出症均可取得满意的短期疗效,但与FD比较,TED创伤更小,手术时间更短,更有利于患者的术后恢复。

Objective To compare the differences of surgical outcomes between transforaminal endoscopic discectomy (TED) and fenestration discectomy (FD) for single-level lumbar disc herniation (LDH). Methods Sixty-nine LDH patients in Jieyang People's Hospital from January 2015 to December 2017 were enrolled and randomly divided into TED ( n = 36) and FD ( n = 33) treating groups according to the random number table. The incision length, operation time, duration of hospitalization, perioperative complications, Japanese Orthopaedic Association (JOA) score and visual analogue scale (VAS) score at the last follow-up were compared between two groups. Results The mean duration of follow-up was (18.8 ± 12.5) months (6 to 25 months). There were no statistical differences between two groups in JOA score, VAS score at the last follow-up, as well as the incidence of perioperative complications;While the incision length, operation time and hospital stay in TED group were shorter than those in FD group ( P <0.05). Conclusions Both TED and FD could obtain satisfactory short-term effects in the treatment of single-level LDH;Compared with FD, TED has the advantages of less trauma, shorter operation time and more rapid rehabilitation.