椎间孔镜导棒滑移结合偏心环锯技术治疗L_(5)/S_(1)腰椎间盘突出症的疗效分析

Curative effect of endoscopic transforaminal guide-bar sliding combined with eccentric trephine technique in the treatment of L_(5)/S_(1)lumbar disc herniation

目的探讨椎间孔镜导棒滑移结合偏心环锯技术治疗L_(5)/S_(1)腰椎间盘突出症的临床疗效。方法选取29例采用椎间孔镜导棒滑移结合偏心环锯技术治疗的L_(5)/S_(1)节段腰椎间盘突出症患者,通过手术前后各时间点的视觉疼痛模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)及末次随访时改良Macnab标准评估其临床治疗效果。结果29例患者均顺利完成手术,未出现神经根损伤、硬膜撕裂等严重并发症。术后2 d、3个月及末次随访时的VAS评分及ODI均较术前降低,差异有统计学意义(P<0.05);末次随访手术效果优15例,良11例,可3例,优良率为89.66%。结论椎间孔镜导棒滑移结合偏心环锯技术治疗L_(5)/S_(1)节段腰椎间盘突出症手术疗效满意。

Objective To explore the clinical efficacy of endoscopic transforaminal guide-bar sliding combined with eccentric trephine technique in the treatment of L_(5)/S_(1)lumbar disc herniation.Methods A total of 29 patients with L_(5)/S_(1)lumbar disc herniation treated by endoscopic transforaminal guide-bar sliding combined with eccentric trephine technique were selected.Visual analogue scale(VAS)score and Oswestry disability index(ODI)at each time point before and after surgery and modified Macnab standard at the last follow-up were used to evaluate the clinical efficacy.Results All 29 patients successfully completed the operation without severe complications such as nerve root injury and dural tear.The VAS score and ODI of 2 days after operation,3 months after operation,and at the last follow-up were lower than those before operation,and the differences were statistically significant(P<0.05).The surgical results at the last follow-up:15 cases were excellent,11 cases were good,3 cases were fair,and the excellent and good rate was 89.66%.Conclusion Endoscopic transforaminal guide-bar sliding combined with eccentric trephine technique has satisfactory clinical efficacy in the treatment of L_(5)/S_(1)lumbar disc herniation.