经皮内镜治疗腰椎间盘突出症临床疗效

Spinal percutaneous endoscopic treatment of patients with lumbar disc herniation

目的:探究经皮内镜治疗腰椎间盘突出症(LDH)的疗效。方法:根据治疗过程中不同入路方式进行治疗的腰椎间盘突出患者分为经椎板间入路组(ID组),经椎间孔入路组(TD组),每组患者34例。ID组和TD组患者一般资料无明显差异。采用Oswestry腰椎功能障碍指数(ODI)、ASIA感觉评分和运动评分、视觉模拟评分(VAS)评估患者腰椎功能、脊髓神经功能恢复、疼痛情况,并观察分析两组患者并发症发生率。结果:治疗前,ID组和TD组患者ODI指数得分、感觉评分、运动评分和疼痛评分均无统计学差异(P>0.05),治疗后两组患者ODI得分和疼痛评分明显降低,感觉评分和运动评分发生明显提高(P<0.05),且各评分结果组间比较差异无统计学意义(P>0.05)。此外,ID组共2例患者出现继发效应,TD组共4例患者出现继发效应,发生率分别为5.88%、11.76%,差异无统计学意义(P>0.05)。结论:采用脊柱经皮内镜下切除术对腰椎间盘突出症临床疗效较佳,其中,椎板间与椎间孔两种手术方法疗效相近,对患者腰椎功能、疼痛情况等影响相差较小。

Objective:To explore the efficacy of spinal percutaneous endoscopy in the treatment of lumbar disc herniation.Methods:According to different approaches during treatment,patients with lumbar disc herniation were divided into translaminar approach group(ID group)and transforaminal approach group(TD group),34 cases in each group.There was no significant difference in the general data of patients between ID group and TD group.The Oswestry Disability Index(ODI),ASIA sensation score and motor score,and visual analog scale(VAS)were used to evaluate the lumbar spine function,spinal nerve function and pain,and to analyze the incidence of symptoms in the two groups.Results:Before treatment,there were no significant differences in ODI index score,sensory score,motor score and pain score between the ID group and TD group(P>0.05).After treatment,ODI score and pain score were significantly decreased,while sensory score and motor score were significantly increased(P<0.05),and there was no statistical significance between groups(P>0.05).In addition,A total of 2 patients in the ID group had secondary effects,and a total of 4 patients in the TD group had secondary effects,and the incidences were 5.88%and 11.76%,respectively.Compared with the TD group,the ID group had more patients with complications,but there was no significant difference(P>0.05).Conclusion:The spinal percutaneous endoscopic resection has better clinical effect on patients with lumbar disc herniation.Among them,the two surgical methods of interlaminar and intervertebral foramen have similar curative effects,and have little difference in patients’lumbar function and pain.