椎间孔镜技术与骨科开放手术治疗腰椎间盘突出并腰椎管狭窄症的临床效果

Clinical effect of intervertebral foramen microscopy and open orthopaedic surgery in the treatment of lumbar intervertebral disc herniation and lumbar spinal stenosis

目的探究与分析椎间孔镜技术与骨科开放手术治疗腰椎间盘突出并腰椎管狭窄症的临床效果。方法选取2015年7月至2018年7月在本院接受临床诊治的90例腰椎间盘突出并腰椎管狭窄症患者作为研究对象,采用随机数字表法将其分为对照组与试验组,每组45例。对照组患者实施骨科开放手术治疗,试验组患者实施经皮椎间孔镜治疗。比较两组患者的治疗效果。结果试验组手术时间及住院时间均明显短于对照组,且出血量明显少于对照组,差异具有统计学意义(P<0.05)。试验组患者术后12、24、48 h的切口VAS评分均显著低于对照组,差异有统计学意义(P<0.05)。术前,两组患者腰痛、腿痛VAS评分比较,差异无统计学意义(P>0.05);术后,试验组腰痛、腿痛VAS评分均低于对照组,但组间比较,差异无统计学意义(P>0.05)。术前,两组患者JOA、ODI评分比较,差异无统计学意义(P>0.05);术后,试验组JOA评分高于对照组,ODI评分低于对照组,但组间比较,差异无统计学意义(P>0.05)。结论在腰椎间盘突出并腰椎管狭窄症临床治疗中,椎间孔镜技术与骨科开放手术临床效果具有相似性,但相较于开放手术,椎间孔镜技术安全性更高,可降低机体创伤风险,促进患者尽早康复。

Objective To explore and analyze the clinical effect of intervertebral foramen microscopy and open orthopaedic surgery in the treatment of lumbar intervertebral disc herniation with lumbar spinal stenosis.Methods Ninety patients with lumbar intervertebral disc herniation and lumbar spinal stenosis who received clinical diagnosis and treatment in our hospital from July 2015 to July 2018 were selected as the research objects and divided into control group and experimental group by random number table method,with 45 cases in each group.The patients in the control group were treated with open orthopaedic surgery,and the patients in the experimental group were treated with intervertebral foramen microscopy.The therapeutic effects of the two groups were compared.Results The operation time and hospitalization time of the experimental group were significantly shorter than those of the control group,and the amount of bleeding was significantly less than that of the control group(P<0.05).The VAS scores of the experimental group at 12,24,48 hours after operation were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).Before operation,there were no significant differences in VAS scores of lumbago and leg pain between the two groups(P>0.05).After operation,the VAS scores of low back pain and leg pain in the experimental group were lower than those in the control group,but there were no significant differences between the two groups(P>0.05).Before operation,there were no significant differences in JOA and ODI scores between the two groups(P>0.05).After operation,the JOA score of the experimental group was higher than that of the control group,the ODI score was lower than that of the control group,but there were no significant differences between the two groups(P>0.05).Conclusion In the clinical treatment of lumbar intervertebral disc herniation with lumbar spinal stenosis,the clinical effect of open orthopaedic surgery is similar to that of intervertebral foramen microscopy,but compared with open orthopaedic surgery,the intervertebral foramen microscopy is safer and can reduce the risk of trauma and promote the early recovery of patients.