后入路椎管减压椎间融合内固定术与经皮椎间孔镜技术治疗胸椎间盘突出症的效果比较

Comparison of effects of posterior approach spinal canal decompression,interbody fusion and internal fixation and percutaneous transforaminal endoscopic discectomy in the treatment of thoracic disc herniation

目的比较后入路椎管减压椎间融合内固定术与经皮椎间孔镜技术治疗胸椎间盘突出症的效果。方法选取2018年1月至2019年12月本院收治的96例胸椎间盘突出症患者为研究对象,随机将其分为参照组和研究组,各48例。参照组行后入路椎管减压椎间融合内固定术治疗,研究组行经皮椎间孔镜技术治疗。比较两组患者的疼痛、功能障碍程度、临床疗效、血清炎性因子水平、手术及康复情况。结果术后1、3个月,研究组的VAS、ODI评分均低于参照组,差异具有统计学意义(P<0.05)。研究组的治疗优良率高于参照组,差异具有统计学意义(P<0.05)。术后1、3个月,研究组的SF、MMP-3、TNF-α、IL-1β水平均低于参照组,差异具有统计学意义(P<0.05)。研究组的手术时间、手术切口长度及住院时间均短于参照组,术中出血量少于参照组,差异具有统计学意义(P<0.05)。结论相较于后入路椎管减压椎间融合内固定术,经皮椎间孔镜技术治疗胸椎间盘突出症患者的效果更好,可缓解疼痛,降低血清炎性因子水平,促进康复。

Objective To compare the effects of posterior approach spinal canal decompression,interbody fusion and internal fixation and percutaneous transforaminal endoscopic discectomy in the treatment of thoracic disc herniation.Methods A total of 96 patients with thoracic disc herniation treated in our hospital from January 2018 to December 2019 were selected as the study objects and randomly divided into reference group and study group,with 48 cases in each group.The reference group was treated with posterior approach spinal canal decompression,interbody fusion and internal fixation,and the study group was treated with percutaneous transforaminal endoscopic discectomy.The degree of pain and dysfunction,clinical efficacy,serum inflammatory factors levels,operation and rehabilitation were compared between the two groups.Results At 1 and 3 months after operation,the VAS and ODI scores of the study group were lower than those of the reference group,and the differences were statistically significant(P<0.05).The excellent and good rate of treatment in the study group was higher than that in the reference group,and the difference was statistically significant(P<0.05).At 1 and 3 months after operation,SF,MMP-3,TNF-αand IL-1βlevels in the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).The operation time,the surgical incision length and hospital stay of the study group were shorter than those of the reference group,the amount of intraoperative bleeding was less than that of the reference group,and the differences were statistically significant(P<0.05).Conclusion Compared with posterior approach spinal canal decompression,interbody fusion and internal fixation,percutaneous transforaminal endoscopic discectomy is more effective in the treatment of patients with thoracic disc herniation,which can relieve pain,reduce the serum inflammatory factors levels and promote rehabilitation.