经皮椎间孔镜下靶向摘除突出髓核治疗腰椎间盘突出症临床效果观察

Clinical observation of transforaminal targeted percutaneous endoscopic lumbar discectomy for lumbar disc herniation

目的观察经皮椎间孔镜下靶向摘除突出髓核治疗腰椎间盘突出症的临床效果。方法选取2014年6月-2016年4月医院收治的腰椎间盘突出症患者65例,所有患者均采用经皮椎间孔镜下靶向摘除突出髓核治疗。比较术前与术后患者下肢痛VAS评分及术前与术后1年Oswestry功能障碍指数(ODI)。结果 65例患者手术均顺利完成,平均随访13个月。治疗术后1 d、3个月、6个月、1年下肢痛VAS评分均低于术前(P<0.05);术后1年ODI为(16.9±6.2)%低于术前的(49.8±10.5)%,差异有统计学意义(P<0.05);术后3个月及6个月各有1例复发,再次行侧路翻修后均康复。结论经皮椎间孔镜下靶向摘除突出髓核治疗腰椎间盘突出症安全、有效,值得临床推广应用。

Objective To observe the clinical effects of transforaminal targeted percutaneous endoscopic lumbar discectomy for lumbar disc herniations.Methods 65 cases of patients with lumbar disc herniation admitted to the hospital from June 2014 to April 2016 were selected,all patients underwent transforaminal targeted percutaneous endoscopic lumbar discectomy.The preoperative and postoperative lower extremity pain visual analog score(VAS) and oswestry disability index(ODI) were compared.Results All 65 patients underwent surgery successfully,with an average follow-up of 13 months.The VAS scores of lower limb pain at 1 d,3 months,6 months and 1 year were lower than those before surgery(P<0.05).The ODI at 1 year after surgery(16.9%±6.2%) was lower than the preoperative(49.8%±10.5%),and the difference was statistically significant(P<0.05).2 patients sufered from recurrent herniation in 3 th month and 6 th month,both obtained rehabilitation by PTED again.Conclusion Transforaminal targeted percutaneous endoscopic lumbar discectomy is safe and effective for lumbar disc herniation.