经皮椎间孔镜技术在腰椎手术失败综合征中的应用

Application of percutaneous endoscopic lumbar discectomy in the failure syndrome of lumbar surgery

目的探讨采用经皮椎间孔镜技术进行翻修手术治疗腰椎手术失败综合征的临床疗效。方法回顾性分析2012年1月-2017年6月该科室28例采用经皮椎间孔镜技术进行翻修手术治疗腰椎手术失败综合征的患者的临床资料。分析患者翻修手术前后腿痛视觉模拟评分(VAS),采用MacNab标准评估再次手术后的临床疗效。结果 28例患者均顺利完成椎间孔镜手术,手术时间55~95 min,平均(62.2±5.5) min;术前腿痛VAS评分为(8.1±0.3)分,术后腿痛VAS评分为(2.6±0.2)分,术前术后比较,差异有统计学意义(P <0.05)。按MacNab功能评定标准:优11例、良14例、可1例、差2例,整体满意度为89.3%。结论对于有手术适应证的腰椎手术失败综合征患者,可选择经皮椎间孔镜技术行翻修手术。

Objective To investigate the clinical effect of reconstruction surgery with percutaneous endoscopic lumbar discectomy for patients with lumbar failure syndrome.Methods The clinical data of 28 patients with lumbar surgery failure syndrome who underwent reconstruction surgery using percutaneous endoscopic lumbar discectomy from January 2012 to June 2017 were retrospectively analyzed.The visual analogue scale(VAS)of the patients before and after revision surgery was statistically analyzed,and the clinical efficacy after reoperation was evaluated using MacNab standard.Results All of the 28 patients successfully completed intervertebral foraminal surgery,and the operation time was 55~95 min,with an average of(62.2±5.5)min,VAS score of leg pain before operation was(8.1±0.3),VAS score of leg pain after operation was(2.6±0.2),the difference was statistically significant before and after operation(P<0.05).According to the MacNab functional assessment criteria:among them,11 cases were excellent,14 cases were good,1 case was fair,2 cases were poor,and the overall satisfaction rate was 89.3%.Conclusion Revision surgery with endoscopic lumbar discectomy is an option for patients with lumbar failure syndrome for which surgical indications are available.