经椎板间隙完全内镜下L4~S1椎间盘摘除术对腰椎间盘突出症的效果探究

Effect of complete endoscopic discectomy through lamina space L4~S1 lumbar disc herniation

目的研究经椎板间隙完全内镜下L4~S1椎间盘摘除术对腰椎间盘突出症的治疗效果。方法选取济南市第四人民医院骨科在2015年10月~2020年5月收治的腰间盘突出症患者88例,按手术方式的不同将患者分为参照组和研究组,各44例,参照组实施传统的开放式腰椎间盘髓核摘除术,研究组实施经椎板间隙完全内镜下L4~S1椎间盘摘除术,分析术后两组患者的身体恢复以及并发症发生的情况。结果术前,研究组和对照组患者VSA评分相比无统计学意义(P>0.05);与对照组相比,研究组的术中出血量、手术时间、术后卧床时间以及术后住院日等术后相关资料明显优于参照组(t=15.385、13.624、11.142、10.301,均P<0.05),差异具有统计学意义;研究组术后1天、术后1个月、术后3个月的VAS评分明显低于参照组(t=4.166、2.299、1.989,均P<0.05),差异具有统计学意义;神经损伤、颈部疼痛、脑脊液漏以及术后椎间盘炎等总并发症的发生率(11.36%)明显低于参照组(34.09%)(χ^(2)=6.471,均P<0.05),差异具有统计学意义。结论对腰椎间盘突出症患者实行经椎板间隙完全内镜下L4~S1椎间盘摘除术进行治疗,促进患者机体功能康复效果与时效,避免发生开放性手术所引起的并发症。

Objective To explore the effect of L4~S1 discectomy under complete interlaminar endoscopy on lumbar disc herniation. Methods Eighty-eight patients with lumbar disc herniation in the Department of Orthopedics of the Fourth People’s Hospital of Jinan from October 2015 to May 2020 were selected and divided into the reference group and the study group according to the different operation methods, with 44 cases in each group. The reference group was treated with traditional open lumbar discectomy, and the study group was treated with L4~S1 discectomy under complete endoscope physical recovery and complications. Results Before operation, there was no significant difference in VSA score between the study group and the control group(P>0.05);Compared with the control group, the intraoperative blood loss, operation time, postoperative bed rest time and postoperative hospital stay of the study group were significantly better than those of the control group(t=15.385, 13.624, 11.142, 10.301, P<0.05), and the VAS score of the study group was significantly lower than that of the control group(t=4.166, P<0.05). The incidence of complications such as nerve injury, neck pain, cerebrospinal fluid leakage and postoperative discitis in the study group(11.36)% was significantly lower than that in the control group(34.09%)(χ^(2)=6.471, P<0.05). Conclusion Patients with lumbar intervertebral disc herniation are treated with complete endoscopic discectomy from L4 to S1 through the interlaminar space, which can promote the recovery effect and timeliness of patients and avoid complications caused by open surgery.