侧后路椎间孔镜后路椎间盘镜技术与开放椎板开窗术治疗腰椎间盘突出症对SLRT得分及炎性因子水平的影响

The Influence of Lateral Posterior Discectomy,Posterior Discectomy and Open Laminoplasty on SLRT Score and Inflammatory Factor Levels in Patients with Lumbar Disc Herniation

目的:对比分析侧后路椎间孔镜、后路椎间盘镜技术与开放椎板开窗术治疗腰椎间盘突出症对直腿抬高实验(SLRT)得分及炎性因子水平的影响。方法:前瞻性分析2018年6月至2019年5月期间在我院住院并接受治疗的腰椎间盘突出症患者90例患者做为对象,采用随机数字表法分为孔镜组和开放组各45例,比较两种不同手术的疗效以及两组患者术前术后的炎性因子水平及对SLRT得分的影响。结果:孔镜组患者术后有效率为97.78%,开放组者术后有效率为84.44%,孔镜组患者术后有效率显著高于开放组患者,差异有统计学意义(P<0.05);术后两组患者的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-17(IL-17)和肿瘤坏死因子-α(TNF-α)和肿瘤坏死因子-γ(TNF-γ)水平较手术前均下降,IL-4水平较手术前均上升,差异有统计学意义(P<0.05),同时孔镜组患者IL-4水平上升幅度和IL-6、IL-8、IL-17、TNF-α、IFN-γ水平下降幅度均大于开放组患者差异有统计学意义(P<0.05);且孔镜组患者SLRT髋关节、膝关节和踝关节屈伸度数较开放组更佳,差异有统计学意义(P<0.05)。结论:椎间孔镜手术对于腰椎间盘突出症患者的炎症反应和疼痛程度的具有抑制作用,且椎间孔镜手术的效果更佳。

Objective:To compare and analyze the effects of lateral posterior intervertebral foramen,posterior intervertebral discoscopy and open laminectomy on SLRT score and inflammatory factor level.Methods:A total of 90 patients with lumbar disc herniation who were hospitalized and treated in our hospital from June 2018 to May 2019 were prospectively analyzed.They were randomly divided into the endoscopic group and the open group,with 45 cases in each group.The curative effects of two different surgical methods,the levels of inflammatory factors before and after operation and the impact on SLRT scores of the two groups were compared.Results:The postoperative efficiency was 97.78%.The postoperative efficiency of the open group was 84.44%.The effective rate was significantly higher in the foramen group than in the open group,and the difference was statistically significant(P<0.05).The levels of interleukin-6(IL-6),interleukin-8(IL-8),interleukin-17(IL-17)and tumor necrosis factor-α(tnf-α)and tumor necrosis factor-γ(tnf-γ)in both groups after surgery were lower than before,IL-4 levels were higher than before,and the difference was statistically significant(P<0.05).There was significant difference in the IL-4 level and IL-6、IL-8、IL-17、TNF-α、IFN-γlevels in the open group(P<0.05);and the number of degrees of flexion and extension SLRT hip,knee and ankle joints in the foramen group was better than that in the open group,with statistically significant difference(P<0.05).Conclusion:Intervertebral foramen surgery can inhibit the inflammatory reaction and pain degree in patients with lumbar disc herniation,and the effect of intervertebral foramen surgery is better.