经皮侧后路椎间孔镜下髓核摘除术治疗腰椎间盘突出症患者的效果

Effects of percutaneous posterior-lateral transforaminal lumbar discectomy in treatment of patients with lumbar disc herniation

目的:观察经皮侧后路椎间孔镜下髓核摘除术治疗腰椎间盘突出症患者的效果。方法:选取57例腰椎间盘突出症患者为研究对象,按照随机数字表法分为研究组29例与对照组28例。对照组采取后路开窗髓核摘除术治疗,研究组采取经皮侧后路椎间孔镜下髓核摘除术治疗。比较两组手术相关指标水平、术后1个月疗效、Lehmann腰椎功能评分、视觉模拟评分法(VAS)评分和并发症发生率。结果:研究组住院时间、下床活动时间、切口长度明显短于对照组,术中失血量明显少于对照组,差异有统计学意义(P<0.05);术后1个月,两组Lehmann腰椎功能评分均明显高于术前,且研究组高于对照组,两组VAS评分均明显低于术前,且研究组明显低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为3.45%,明显低于对照组的28.57%,差异有统计学意义(P<0.05);两组手术优良率比较,差异无统计学意义(P>0.05)。结论:经皮侧后路椎间孔镜下髓核摘除术治疗腰椎间盘突出症患者可降低手术相关指标水平、并发症发生率和VAS评分,以及提高腰椎功能评分,效果优于后路开窗髓核摘除术治疗效果。

Objective:To observe effects of percutaneous posterior-lateral transforaminal lumbar discectomy in treatment of patients with lumbar disc herniation.Methods:57 patients with lumbar disc herniation were selected as the research objects,and were divided into study group(29 cases)and control group(28 cases)according to the random number table method.The control group was treated with posterior fenestration discectomy,while the study group was treated with percutaneous posterior-lateral transforaminal lumbar discectomy.The levels of operationrelated indicators,the efficacy 1 month after operation,the Lehmann lumbar function score,the visual analog scale(VAS)score and the incidence of complications were compared between the two groups.Results:The hospitalization time,out-of-bed activity time,and incision length of the study group were significantly shorter than those of the control group;the intraoperative blood loss was significantly less than that of the control group;and the difference was statistically significant(P<0.05).1 month after the surgery,the Lehmann lumbar function scores of the two groups were significantly higher than those before the surgery,and that of the study group was higher than that of the control group;the VAS scores of the two groups were significantly lower than those before the surgery,and that of the study group was significantly lower than that of the control group;and the difference was statistically significant(P<0.05).The complication rate in the study group was 3.45%,which was significantly lower than 28.57%in the control group,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the excellent and good rate of surgery between the two groups(P>0.05).Conclusions:Percutaneous posterior-lateral transforaminal lumbar discectomy in the treatment of the patients with lumbar disc herniation can reduce the levels of operation-related indicators,the incidence of complications and the VAS score,and improve the lumbar function score.Moreover,it is superior to posterior fenestration discectomy.