经皮椎间孔镜髓核摘除术治疗腰椎管狭窄症的效果观察

Effect observation of percutaneous transforaminal endoscopic discectomy in treatment of lumbar spinal stenosis

目的探讨经皮椎间孔镜髓核摘除术(PTED)治疗腰椎管狭窄症(SLSS)的效果。方法选取2018年1月~2019年12月上饶市第五人民医院收治的60例SLSS患者,采用随机数字表法分为对照组(30例)与观察组(30例)。对照组采用传统开放手术减压并后路椎体间融合术方法,观察组采用PTED方法,对两组临床疗效、临床指标、疼痛程度、腰椎功能及并发症发生情况进行比较。结果观察组患者治疗效果优于对照组,治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组切口长度、住院时间及手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组术后功能障碍指数(ODI)评分、视觉模拟量表(VAS)评分均低于术前,差异有统计学意义(P<0.05);术后观察组的ODI评分及VAS评分低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论PTED对SLSS患者治疗效果显著,创伤较小,可有效缓解术后疼痛,改善腰椎功能,有利于患者的术后恢复,且并发症较少。

Objective To investigate the effect of percutaneous transforaminal endoscopic discectomy(PTED)in treatment of lumbar spinal stenosis(SLSS).Methods A total of 60 patients with SLSS admitted to Shangrao Fifth People′s Hospital from January 2018 to December 2019 were selected.By random number table method,they were divided into two groups,namely a control group(30 cases)and an observation group(30 cases).The control group underwent traditional open surgery decompression and posterior lumbar interbody fusion,and observation group was treated with PTED.The clinical efficacy,clinical indicators,pain degree,lumbar function and complications of the two groups were compared.Results The clinical efficacy of patients in the observation group was better than that of the control group,and the total effective rate was higher than that of the control group,with statistically significant differences(P<0.05).The length of incision,hospital stay and operation time in the observation group were shorter than those of the control group,and intraoperative blood loss was less than that of the control group,the differences were significant statistically(P<0.05).The postoperative dysfunction index(ODI)score and the visual analogue scale(VAS)score of the two groups were lower than those before operation,the differences were significant statistically(P<0.05);The ODI and VAS scores of the observation group after operation were lower than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in observation group was lower than that in control group,and the difference was significant statistically(P<0.05).Conclusion PTED has a significant effect on patients with SLSS.It has less trauma,can effectively relieve postoperative pain,improve lumbar spine function,is beneficial to the patients′postoperative recovery,and has fewer complications.PTED has a significant therapeutic effect on SLSS patients with less trauma,and can effectively relieve postoperative pain and improve lumbar function,which is conducive to the patients′postoperative recovery,with fewer complications.