比较经皮侧路镜BESI技术与TESSY技术在L5~S1椎间盘突出症中的临床应用

Comparison of the clinical application of percutaneous endoscopic TESSY and BESI technology in L^S disc herniation

目的比较经皮侧路镜BEIS技术与TESSY技术在L5~S1椎间盘突出症中的临床应用,并评估其临床应用价值。方法选取2018年1月~2019年6月佛山市第六人民医院治疗的60例L5~S1椎间盘突出症患者,随机分为BEIS技术组(观察组)和TESSY技术组(对照组)两组,各30例,并进行6~18月随访,比较两组患者性别构成、年龄、手术时间、术中C臂X光机透视次数、术后并发症及手术效果。以评价不同技术的治疗效果及临床价值。结果 60例患者平均随访12月,两组性别、年龄无统计学差异(P>0.05),BEIS技术组较TESSY技术组手术时间短,C臂透视次数少,差异有统计学意义(P<0.05),术后6月及末次随访,两组患者VAS及ODI评分无统计学意义(P>0.05),并使用改良的MacNab标准评价术后1年患者的疗效无统计学差异(P>0.05)。两组各有1例术后复发,经二次手术后均恢复良好,术后并发症发生率无统计学差异(P>0.05)。结论经皮内镜BEIS与TESSY技术治疗L5~S1椎间盘突出症均为安全有效的微创治疗方案,BEIS技术操作更易掌握,手术操作时间及术中透视方面在L5~S1椎间盘突出症有一定的优势。

Objective To compare the clinical application of percutaneous endoscopic BEIS and TESSY technology in L5~S1 disc herniation and to evaluate its clinical value. Methods Sixty patients with L5-S1 disc herniation treated by Foshan Sixth People’s Hospital from January 2018 to June 2019 were collected and were randomly divided into the following two groups: a BEIS technology group(observation group) and a TESSY technology group(control group), each with 30 cases, and were followed up for 6~18 months. The gender, age, time of operation, number of X-ray machines in C-arm during operation, postoperative complications and surgical results were compared between the two groups to evaluate the therapeutic effect and clinical value of different techniques. Results Sixty patients were followed up for 12 months on average, there were no statistical difference in gender, age of the two groups(P>0.05). Compared with the TESSY group, the BEIS group had shorter operation time and fewer C-arm fluoroscopy, with statistically significant difference(P<0.05). During the 6 months after surgery follow-up and the last time follow-up, there were no statistical difference in the VAS and ODI scores of the two groups(P>0.05). There was one case of postoperative recurrence in each of the two groups, both recovered well after the second open operation, and there was no statistical difference in the incidence of postoperative complications(P>0.05). Conclusions Percutaneous endoscopic BEIS and TESSY are safe, effective and minimally invasive treatments for L5~S1 disc herniation and BEIS is easier to master. BEIS technology have certain advantages in the operation time and intraoperative perspective on treatment of the L5~S1 disc herniation.