椎间孔镜下可视化椎间孔成形术治疗腰椎间盘突出症的安全性及临床疗效分析

Safety and clinical effect analysis of percutaneous endoscopic lumbar discectomy by visual foraminoplasty for treating lumbar disc herniation

目的探讨可视化椎间孔成形术治疗腰椎间盘突出症的安全性及临床疗效。方法选择2016年1月1日至2016年12月31日于成都中医药大学附属医院行椎间孔入路经皮内镜下髓核摘除术的71例患者,分为对照组和观察组。对照组29例患者行经典TESSYS术,观察组42例患者行可视化椎间孔成形术,比较两组患者疗效及安全性。结果两组患者术前及末次随访时的VAS及ODI评分比较,差异均无统计学意义(P>0.05),对照组及观察组末次随访较术前均明显改善(P<0.01)。观察组的手术操作时间、透视次数均明显低于对照组,差异有统计学意义(P<0.01),但住院时间比较差异无统计学意义(P>0.05)。根据改良Macnab评定标准评定优良率,对照组优良率93.10%,观察组优良率92.86%,差异无统计学意义(P>0.05)。结论椎间孔镜下可视化椎间孔成形术治疗腰椎间盘突出症安全有效,且操作更加简便、手术用时更短、放射暴露更少。

Objective To explore the safety and clinical efficacy of visible foraminoplasty for treating lumbar disc herniation.Methods A total of 71 patients undergoing percutaneous endocopic discectomy by intervertebral foramen approach in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from January 1,2015 to December 31,2016 were selected and divided into the control group and observation group.The control group(29 cases)conducted the classic TESSYS technique and observation group(42 cases)conducted the visual foraminoplasty.Then the differences in the treatment effects and safety were compared between the two groups.Results There was no significant difference in VAS and ODI scores between the two groups before and during the last follow-up(P>0.05).The last follow-up of the control group and the observation group improved significantly(P<0.01),the operation time and fluoroscopy times of the observation group were significantly lower than those of the control group(P<0.01),but there was no significant difference in hospitalization time(P>0.05).According to excellent and good rate according to the improved macnab evaluation standard,the excellent and good rate in the control group was 93.10%,which in the observation group was 92.86%,and the difference was not statistically significant(P>0.05).Conclusion The visual foraminoplasty under intervertebral foramen endoscopy for treating lumbar disc herniation is safe and effect,moreover with more simple in operating,shorter operation time and less radiation exposure.