镜下磨钻辅助的可视化椎间孔成形治疗腰椎间盘突出症的临床应用

Clinical application of visualized foraminoplasty assisted by microscopic grinding and drilling in the treatment of lumbar disc herniation

目的探讨镜下磨钻辅助的可视化椎间孔成形治疗腰椎间盘突出症的临床疗效。方法36例行镜下磨钻辅助的可视化椎间孔成形患者为可视化组,33例行TESSYS成形患者为对照组。比较两组透视次数、手术时间,术前、术后采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、改良MacNab标准等评价临床疗效。结果可视化组透视次数、手术时间低于对照组(P<0.05)。两组术前、术后和末次随访VAS评分、ODI指数比较,差异无统计学意义(P>0.05)。依据改良MacNab标准,末次随访时,两组优良率比较,差异无统计学意义(P>0.05)。结论镜下磨钻辅助下的经皮内镜椎间孔成形治疗腰椎间盘突出症较传统TESSYS技术具有放射暴露少、操作安全、学习曲线平缓的优点,且可获得与TESSYS技术相当的临床效果。

Objective To investigate the clinical efficacy of visualized foraminoplasty assisted by microscopic grinding drill in the treatment of lumbar disc herniation.Methods Thirty-six patients with lumbar disc herniation treated with visualized foraminoplasty assisted by microscopic grinding drill,were classified as visualization group.Another 33 patients with lumbar disc herniation,whoused transforaminal endoscopic spine system(TESSYS),were classified as control group.The number of fluoroscopies,operation time,preoperative and postoperative pain visual analog score(VAS),Oswestry Disability Index(ODI)and modified MacNab criteria were used to evaluate the clinical efficacy of the two groups.Results The number of fluoroscopic views and operation time were lower in the visualization group than those in the control group(P<0.05).There was no statistically significant difference in the preoperative,postoperative and final follow-up VAS scores and ODI index between the twogroups(P>0.05).Based on the modified MacNab criteria,there was no statistically significant difference when comparing the excellent rates of the two groups at the final follow-up(P>0.05).Conclusion Percutaneous endoscopic foraminoplasty assisted by microscopic grinding drill in the treatment of lumbar disc herniation has the advantages of less radiation exposure,safer operation and flatter learning curve than the conventional TESSYS technique besides achievingthe clinical results comparable to those of the TESSYS technique.