经皮椎间孔镜腰椎间盘切除术与椎板开窗腰椎间盘切除术治疗腰椎间盘突出症的效果比较

Percutaneous endoscopic lumbar discectomy versus lumbar discectomy with vertebral fenestration in the treatment of lumbar disc herniation

目的比较经皮椎间孔镜腰椎间盘切除术(PELD)与椎板开窗腰椎间盘切除术治疗腰椎间盘突出症的效果。方法将200例腰椎间盘突出症患者随机分为2组各100例。对照组采用椎板开窗腰椎间盘切除术治疗,研究组采用PELD治疗。比较2组疗效。结果研究组手术时间、下床活动时间、住院时间、术中出血量、切口长度均显著优于对照组(P<0.05)。术后3、6个月时,研究组Oswestry功能障碍指数(ODI)显著低于对照组(P<0.05)。治疗后,研究组Mac Na优良率为92.00%,显著高于对照组的82.00%(P<0.05)。研究组术后并发症发生率显著低于对照组(P<0.05)。结论PELD治疗腰椎间盘突出症安全、有效,具有创伤小、出血少、恢复快、并发症少等特点,可改善腰椎功能。

Objective To compare the effect of percutaneous endoscopic lumbar discectomy(PELD)and lumbar discectomy with vertebral?fenestration in the treatment of lumbar disc herniation.Methods A total of 200 patients with lumbar disc herniation were randomly divided into two groups,with 100 cases in each group.Control group was treated by lumbar discectomy with vertebral fenestration,while study group was treated by PELD.The efficacy was compared between two groups.Results The operation time,time to get out of bed for activity,hospitalization time,intraoperative bleeding volume and incision length of the study group were significantly better than those of the control group(P<0.05).At 3 and 6 months after operation,the Oswestry dysfunction index(ODI)in the study group was significantly lower than that in the control group(P<0.05).After treatment,the excellent and good rate of MacNa in the study group was 92.00%,which was significantly higher than 82.00%in the control group(P<0.05).The incidence rate of postoperative complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion PELD is safe and effective in the treatment of lumbar disc herniation,which has the characteristics of less trauma,less bleeding,fast recovery and fewer complications,and it can improve lumbar function.