椎间孔镜微创与开放性手术治疗单节段腰椎间盘突出效果观察

Effect of Intervertebral Foramen Minimally Invasive and Open Surgery on Single-segment Lumbar Disc Herniation

目的:对比分析经椎间孔内镜脊柱系统(transforaminal endoscopic spine system,TESSYS)与开放性手术治疗单节段腰椎间盘突出效果。方法:选取2016年2月-2018年12月收治的单节段腰椎间盘突出患者94例,随机分为两组,观察组给予经椎间孔镜微创手术治疗,对照组给予开放性手术治疗,比较两组临床指标,术后6个月疗效,术前、术后1周、3个月、6个月VAS、ODI评分,术后并发症发生情况。结果:观察组手术时间、术后卧床时间、住院时间、切口长度均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);观察组治疗优良率高于对照组,差异有统计学意义(P<0.05);术前两组VAS、ODI评分比较差异无统计学意义(P>0.05),术后1周观察组VAS、ODI评分均低于对照组,差异均有统计学意义(P<0.05),术后3、6个月两组VAS、ODI评分比较差异无统计学意义(P>0.05);两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:TESSYS手术治疗单节段腰椎间盘突出临床效果显著,减小创伤,减少术中出血量,缓解患者术后疼痛,促进患者腰椎功能恢复,值得在临床上推广。

Objective:To compare the minimally invasive and open surgery of intervertebral foramen for the treatment of single-segment lumbar disc herniation.Method:A total of 94 patients with single-segment lumbar disc herniation admitted to our hospital from February 2016 to December 2018 were selected and were divided into the observation group and the control group randomly.The observation group was treated with minimally invasive surgery and the control group was treated with open surgery.The clinical indexes,the efficacy of the patients after 6 months,the preoperative,postoperative 1 week,3 months,6 months VAS,ODI score,postoperative complications of the two groups were compared.Result:The operative time,postoperative bed rest time,hospitalization time and incision length of the observation group were shorter than those of the control group,the amount of bleeding in the observation group was less than that in the control group,the differences were statistically significant(P<0.05).The excellent and good rate of treatment in the observation group was higher than that in the control group(P<0.05).There was no significant difference in VAS and ODI scores between the two groups before operation(P>0.05).The VAS and ODI scores in the observation group were lower at 1 week after operation than in the control group(P<0.05).There was no significant difference in VAS and ODI scores between the two groups at 3 and 6 months after operation(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Transforaminal endoscopic spine system surgery for single-segment lumbar intervertebral disc,the clinical effect is prominent,reduce the trauma,reduce the intraoperative blood loss,the postoperative pain is relieved,and the lumbar spine function recovery is promoted.It is recommended to be clinically popularized.