PTED与MED治疗腰椎间盘突出症患者的临床效果比较

Comparison of clinical effects of PTED and MED in treatment of patients with lumbar disc herniation

目的:比较经皮椎间孔镜下髓核切除术(PTED)与显微内镜下腰椎间盘摘除术(MED)治疗腰椎间盘突出症患者的临床效果。方法:回顾性分析2018年1月至2019年6月收治的80例腰椎间盘突出症患者的临床资料。根据手术方案不同分为观察组和对照组各40例,观察组行PTED治疗,对照组行MED治疗,比较两组患者手术参数指标水平、手术前后腰椎功能、下肢疼痛评分及腰椎的稳定性。结果:观察组患者切口长度、术后卧床时间及住院时间均短于对照组,手术时间长于对照组,差异均有统计学意义(P<0.05)。术前,两组患者日本骨科学会量表(JOA)评分和视觉模拟评分量表(VAS)评分比较,差异均无统计学意义(P>0.05);术后,两组患者JOA评分均高于术前,VAS评分均低于术前,差异有统计学意义(P<0.05);组间比较,差异无统计学意义(P>0.05)。手术前后,两组患者腰椎前曲度Cobb角及椎间隙高度比较,差异均无统计学意义(P>0.05);组间比较,差异无统计学意义(P>0.05)。结论:PTED与MED治疗腰椎间盘突出症患者疗效相当,但PTED创伤小、术后恢复快。

Objective: To compare clinical effects of percutaneous transforaminal endoscopic discectomy(PTED) and microendoscopic discectomy(MED) in treatment of patients with lumbar disc herniation. Methods: The clinical data of 80 patients with lumbar disc herniation from January 2018 to June 2019 were retrospectively analyzed. According to different surgical protocols, they were divided into observation group and control group, 40 cases in each. The observation group was treated with PTED, while the control group was treated with MED. The surgical parameter index levels, postoperative lumbar function, lower limb pain score and lumbar stability were compared between the two groups. Results: The incision length, postoperative bed rest time and hospital stay in the observation group were shorter or lower than those in the control group, the operation time was longer than that in the control group, and the differences were statistically significant(P<0.05). Before the surgery, there were no statistically significant differences in the Japanese orthopaedic association scale(JOA) score and the visual analog scale(VAS) score between the two groups(P>0.05). After the surgery, the JOA scores of the two groups were higher than those before the surgery, the VAS scores were lower than those before the surgery, and the differences were statistically significant(P<0.05);however, the differences were not statistically significant between the two groups(P>0.05). Before and after the surgery, there were no significant differences in the lumbar anterior curvature Cobb angle and intervertebral space height between the two groups(P>0.05);and the differences were not statistically significant between the two groups(P>0.05). Conclusions: PTED and MED are equally effective in the treatment of lumbar disc herniation, but PTED is less invasive and the patients recovers quickly after the surgery.