经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症疗效观察

Effect of percutaneous transforaminal endoscopic discectomy for lumbar disc herniation

目的探讨经皮椎间孔镜下髓核摘除术(PTED)与小切口椎板间开窗髓核摘除术(SIIF)治疗腰椎间盘突出症(LDH)的近期效果及对腰椎功能的影响。方法按照髓核摘除方式的不同将124例LDH住院患者分为2组。对照组62例患者行SIIF术,研究组62例患者行PTED术。观察2组患者手术优良率、手术指标、腰椎功能及手术并发症的发生情况。结果研究组手术优良率为87.10%(54/62),对照组为82.26%(51/62),2组比较差异无统计学意义(P>0.05);研究组手术切口长度、术中出血量均显著优于对照组(P<0.05);研究组手术时间、住院时间均显著短于对照组(P<0.05);2组术后JOA评分显著提高,术后ODI评分显著降低,但研究组术后JOA评分和术后ODI评分变化幅度均显著大于对照组(P<0.05);研究组术后并发症发生率为3.23%(2/62),显著低于对照组的16.13%(10/62)(P<0.05)。结论2种手术治疗LDH的疗效相当,但PTED能显著改善手术指标,恢复腰椎功能,降低并发症发生率。

Objective To study the short-term effect of percutaneous transforaminal endoscopic discectomy(PTED)and small-incision interlaminar fenestration(SIIF)in the treatment of lumbar disc herniation(LDH)and their effects on lumbar spine function.Methods According to different methods of nucleus pulposus removal,124 LDH inpatients were divided into two groups,a total of 62 patients in the control group underwent SIIF surgery and another 62 patients in the study group underwent PTED surgery.The excellent and good rate of operation,operation indexes,lumbar function and the occurrence of surgical complications were observed in the two groups.Results The surgical excellent rate in the study group was 87.10%(54/62),and 82.26%(51/62)in the control group,but there was no significant difference(P>0.05).The surgical incision length and intraoperative blood loss in the study group were significantly better than those in the control group(P<0.05),the operation time and hospital stay of the study group were significantly shorter than those of the control group(P<0.05).The JOA score was increased and the ODI score was reduced in both groups,but the study group changed more significantly in JOA score and ODI score than that of the control group(P<0.05);the incidence of postoperative complications in the study group was 3.23%(2/62),which was significantly lower than 16.13%(10/62)of the control group(P<0.05).Conclusion Both SIIF and PTED have similar surgical effects in treating LDH,but PTED can significantly improve surgical indexes,restore lumbar function,and reduce incidence of complications.