椎间孔镜技术治疗腰椎间盘突出症并神经根管狭窄的临床应用价值

The clinical application value of transforaminal endoscopic technique in the treatment of lumbar disc herniation and nerve root canal stenosis

目的观察椎间孔镜TESSYS技术治疗腰椎间盘突出症并神经根管狭窄的临床疗效。方法63例腰椎间盘突出症并神经根管狭窄患者,采用椎间孔镜TESSYS技术治疗。随访1年,于术后第1天及第6、12个月观察并记录所有患者Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)、日本骨科协会评估治疗(JOA)评分。结果术中手术时间为(72.2±11.3)min、X线透视次数为(13.2±3.5)次相对合理,出量少,为(8.5±1.3)ml,无神经、大血管、硬膜囊损伤。此外,在治疗过程中,全部患者均未见肝、肾功能损伤及严重药物不良反应。术后第1天、第6个月、第12个月患者VAS评分分别为(3.76±1.35)、(2.15±0.53)、(2.17±0.52)分,均低于术前的(7.11±0.68)分,差异均具有统计学意义(P<0.05)。术后第1天、第6个月、第12个月患者ODI指数分别为(41.4±10.3)、(25.6±3.8)、(16.2±5.4)%,均低于术前的(75.2±10.1)%,差异均具有统计学意义(P<0.05)。术后第1天、第6个月、第12个月患者JOA评分分别为(16.8±0.5)、(24.5±2.2)、(26.4±1.3)分,均高于术前的(12.2±1.2)分,差异均具有统计学意义(P<0.05)。结论椎间孔镜TESSYS技术治疗腰椎间盘突出症并神经根管狭窄疗效满意,可以有效改善疼痛,恢复肢体功能。

Objective To observe the clinical efficacy of transforaminal endoscopic transforaminal endoscopic spine system(TESSYS)technique in the treatment of lumbar disc herniation and nerve root canal stenosis.Methods 63 patients with lumbar disc herniation and nerve root canal stenosis were treated with TESSYS technique.All patients were followed up for 1 year,the Oswestry dysfunction index(ODI),visual analog scale(VAS),and Japan Orthopedic Association(JOA)scores on the 1 st day,sixth and 12 th months after operation were observed and recorded.Results Intraoperative operation time was(72.2±11.3)min,X-ray fluoroscopy was(13.2±3.5)times,which was relatively reasonable,and blood loss was(8.5±1.3)ml.No nerve,large blood vessel,or dural sac injury was found.In addition,during the treatment,no liver and kidney function damage and serious adverse drug reactions were seen in all patients.On the 1 st day,sixth and 12 th months after operation,VAS score of patients were(3.76±1.35),(2.15±0.53)and(2.17±0.52)points,which were all lower than(7.11±0.68)points before operation,and the difference was statistically significant(P<0.05).On the 1 st day,sixth and 12 th months after operation,ODI of patients were(41.4±10.3),(25.6±3.8)and(16.2±5.4)%,which were all lower than(75.2±10.1)%before treatment,and the difference was statistically significant(P<0.05).On the 1 st day,sixth and 12 th months after operation,JOA score of patients were(16.8±0.5),(24.5±2.2)and(26.4±1.3)points,which were all higher than(12.2±1.2)points before operation,and the difference was statistically significant(P<0.05).Conclusion Transforaminal endoscopic TESSYS technique has satisfactory efficacy for the treatment of lumbar disc herniation and nerve root canal stenosis,and it can effectively improve pain and restore limb function.