经皮椎间孔镜手术对单节段单侧腰椎间盘突出症患者手术恢复及腰椎功能的影响

Effects of percutaneous transforaminal endoscopic surgery on surgical recovery and lumbar function in patients with single segment unilateral lumbar disc herniation

目的探讨经皮椎间孔镜手术对单节段单侧腰椎间盘突出症(LDH)患者手术恢复及腰椎功能的影响。方法按治疗方式将80例单节段单侧LDH患者分为对照组和观察组,各40例。对照组行开放椎板间开窗术,观察组行经皮椎间孔镜手术。比较两组的治疗效果。结果观察组的术中出血量少于对照组,切口长度、卧床时间、住院时间短于对照组(P<0.05)。术后1个月,观察组的腰椎前凸角度、腰骨倾斜角、腰椎曲度、腰背伸肌力、腰背屈/伸比值(F/E)均优于对照组(P<0.05)。出院时及术后1、3个月,观察组的ODI、JOA评分均优于对照组(P<0.05)。结论与开放椎板间开窗术比较,采用经皮椎间孔镜手术治疗单节段单侧LDH患者在手术恢复及功能改善方面更具优势。

Objective To investigate the effects of percutaneous transforaminal endoscopic surgery on surgical recovery and lumbar function in patients with single segment unilateral lumbar disc herniation(LDH).Methods Eighty patients with single segment unilateral LDH were divided into control group and observation group according to the treatment method,with 40 cases in each group.The control group underwent open interlaminar fenestration,and the observation group underwent percutaneous transforaminal endoscopic surgery.The therapeutic effects of the two groups were compared.Results The amount of intraoperative bleeding in the observation was less than that in the control group,incision length,bed stay and hospital stay were shorter than those in the control group(P<0.05).One month after operation,the lumbar lordosis angle,lumbar bone inclination angle,lumbar curvature,lumbar back extensor muscle strength,lumbar back extensor activity and lumbar back flexion/extension ratio(F/E)in the observation group were better than those in the control group(P<0.05).At discharge and 1 and 3 months after operation,the ODI and JOA scores in the observation group were better than those in the control group(P<0.05).Conclusion Compared with open interlaminar fenestration,percutaneous transforaminal endoscopic surgery in the treatment of patients with single segment and unilateral LDH has more advantages in surgical recovery and functional improvement.