椎间孔镜和常规椎板间开窗髓核摘除治疗老年腰椎间盘突出症的临床效果对比

Comparison of Clinical Effects of Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy in the Treatment of Elderly Patients with Lumbar Disc Herniation

目的:对比椎间孔镜(PTED)和常规椎板间开窗髓核摘除(FD)治疗老年腰椎间盘突出症的临床效果。方法:回顾性分析2015年6月-2020年6月笔者所在医院收治的老年腰椎间盘突出症患者72例,根据治疗方式不同分为A组(38例)和B组(34例),A组采用PTED治疗,B组采用FD治疗。比较两组治疗效果,治疗前后VAS评分、ODI评分,术中出血量、手术切口长度、术后住院天数及手术并发症发生情况。结果:A组优良率高于B组(93.88%vs 69.39%,P<0.05);治疗后两组VAS评分、ODI评分较治疗前均降低(P<0.05),但两组间比较差异无统计学意义(P>0.05);A组术中出血量、手术切口长度、术后住院时间均优于B组(P<0.05);A组手术并发症发生率较B组低(7.89%vs 26.47%,P<0.05)。结论:PTED和FD治疗老年腰椎间盘突出症的疗效相同,但PTED创伤更小、恢复更快,且手术并发症少。

Objective:To compare the clinical effect of percutaneous transforaminal endoscopic discectomy(PTED)and fenestration discectomy(FD)in the treatment of elderly patients with lumbar disc herniation.Method:A retrospective analysis of 72 elderly patients with lumbar disc herniation was treated in our hospital from June 2015 to June 2020.According to different treatment methods,they were divided into group A(38 cases)and group B(34 cases).Group A was treated with PTED and group B was treated with FD.The treatment effect,VAS score,ODI score,intraoperative blood loss,length of surgical incision,postoperative hospitalization duration and surgical complications were compared between the two groups.Result:The excellent and good rate of group A(93.88%)was higher than that of group B(69.39%),the difference was statistically significant(P<0.05).The VAS score and ODI score of the two groups after treatment were lower than those before treatment(P<0.05),but there were no differences between the two groups after treatment(P>0.05).The intraoperative blood loss,surgical incision length,and postoperative hospital stay were better in group A than those in group B(P<0.05).Group A had lower surgical complications rate than group B(7.89%vs 26.47%,P<0.05).Conclusion:PTED and FD have the same effect in the treatment of elderly lumbar disc herniation,but PTED has less trauma,faster recovery and fewer surgical complications.