经皮内镜椎板间入路椎间盘切除术治疗L_(5)~S_(1)游离型腰椎间盘突出症

Percutaneous endoscopic interlaminar discectomy for free lumbar disc herniation of L_(5)~S_(1)

目的探讨经皮内镜椎板间入路椎间盘切除术(PEID)治疗L_(5)~S_(1)游离型腰椎间盘突出症的临床疗效。方法采用PEID治疗41例L_(5)~S_(1)游离型腰椎间盘突出症患者。记录疼痛VAS评分、JOA评分、ODI。术后12个月采用改良MacNab标准评价临床疗效。结果手术时间55~98(76.50±20.16) min,住院时间2~9(5.07±2.93) d。患者均获得随访,时间12~20(16.50±3.35)个月。术后24 h及3、12个月VAS评分、JOA评分、ODI均明显优于术前(P <0.05)。术后12个月采用改良MacNab标准评价临床疗效:优31例,良7例,可2例,差1例,优良率92.68%(38/41)。结论采用PEID治疗L5~S1游离型腰椎间盘突出症手术创伤小、操作简单、临床疗效满意。

Objective To investigate the clinical effect of percutaneous endoscopic interlaminar discectomy( PEID)in the treatment of free lumbar disc herniation of L_(5)~S_(1). Methods The 41 cases with free lumbar disc herniation of L_(5)~S_(1) were treated by PEID. The pain visual analogue score( VAS),JOA score,Oswestry dysfuntion index( ODI)were recorded. At 12 months after operation,the clinical effect was evaluated according to MacNab criteria. Results The operation time was 55 ~ 98( 76. 50 ± 20. 16) min,the length of hostpital stay was 2 ~ 9( 5. 07 ± 2. 93) d. The patients were followed up for 12 ~ 20( 16. 50 ± 3. 35) months. The VAS,JOA score and ODI at 24 h,3 months,12 months posoperation were superior to the preoperation( P < 0. 05). At postoperative 12 months,the assessment result of modified MacNab criteria was that 31 cases were excellent,7 good,2 fair and 1 poor,the excellent and good rate was 92. 68%( 38/41). Conclusions PEID has less trauma,and simpler operative procedure and satisfactory effect in the treatment of free lumbar disc herniation of L_(5)~S_(1).