脊柱内镜治疗腰椎间盘突出症致马尾神经损伤的短期疗效

The Short Term Efficacy of Spinal Endoscopy in the Treatment of Cauda Equina Nerve Injury Caused by Lumbar Disc Herniation

目的:探讨脊柱内镜治疗腰椎间盘突出症致马尾神经损伤的短期效果。方法:回顾性选取2018年1月-2020年1月本院收治的60例腰椎间盘突出症致马尾神经损伤患者的资料,依据手术方法分为脊柱内镜组(采用经皮内窥镜下腰椎间盘切除术)和扩大开窗组组(采用扩大开窗髓核摘除术),各30例。观察比较两组患者的VAS评分、术后并发症发生情况、临床疗效和手术前后神经功能分级。结果:脊柱内镜组的VAS评分显著低于扩大开窗组(P<0.05)。脊柱内镜组术后并发症发生率为3.3%,低于扩大开窗组的23.3%,差异有统计学意义(P<0.05)。脊柱内镜组优良率为96.7%,高于扩大开窗组的70.0%,差异有统计学意义(P<0.05)。术后,脊柱内镜组神经功能分级情况优于术前和扩大开窗组,差异均有统计学意义(P<0.05)。结论:在腰椎间盘突出症致马尾神经损伤的治疗中,脊柱内镜的短期临床疗效较扩大开窗法更好,更有助于神经功能恢复,值得临床应用推广。

Objective:To investigate the short term efficacy of spinal endoscopy in the treatment of cauda equina nerve injury caused by lumbar disc herniation.Method:A total of 60 patients with cauda equina nerve injury caused by lumbar disc herniation in our hospital from January 2018 to January 2020 were retrospectively selected.According to the surgical methods,the patients were divided into the spinal endoscopy group (percutaneous endoscopic lumbar discectomy) and the extended fenestration group (resection of the nucleus pulposus),30 cases in each group.The VAS scores,postoperative complications and clinical efficacy,neurological function grading before and after surgery of the two groups were statistically analyzed.Result:The VAS score of the spinal endoscopy group was significantly lower than that of the expanded fenestration group (P<0.05).The incidence of postoperative complications was 3.3% in the spinal endoscopy group,lower than 23.3% in the expanded fenestration group,with statistically significant difference (P<0.05).The rate of excellent and good in the spinal endoscopy group was 96.7%,higher than 70.0% in the expanded window group,with statistically significant difference (P<0.05).After surgery,the neurological function grade of the spinal endoscopy group was better than that preoperative and expanded fenestration group,the differences were statistically significant (P<0.05).Conclusion:In the treatment of cauda equina nerve injury caused by lumbar disc herniation,the short-term clinical efficacy of spinal endoscopy is better than that of the expanded fenestration method,more conducive to the recovery of nerve function,which is worthy of clinical application and promotion.