脊柱内镜下椎板间入路手术治疗腰椎间盘突出症的临床效果

Clinical Effect of Spinal Endoscopic Interlaminar Approach Surgery in the Treatment of Lumbar Disc Herniation

目的探析脊柱内镜下椎板间入路手术治疗腰椎间盘突出症(LDH)的临床效果。方法选取2017年10月至2021年10月安阳市第三人民医院接诊的278例LDH患者作为研究对象。根据随机数表法将其分为对照组(139例)和观察组(139例),对照组接受经椎间孔入路手术治疗,观察组接受脊柱内镜下椎板间入路手术治疗。比较两组患者手术及恢复指标(手术时间、C臂X线照射次数、术后卧床时间以及住院时间)、手术优良率[根据腰椎Oswestry功能障碍指数问卷表(ODI)判定];记录并比较两组术后并发症情况。结果观察组手术时间、术后卧床时间、住院时间短于对照组,且C臂X线照射次数少于对照组,差异有统计学意义(P<0.05);术后1个月,观察组手术优良率高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率、复发率与对照组比较,差异无统计学意义(P>0.05)。结论脊柱内镜下椎板间入路手术治疗LDH效果显著,可缩短手术时间,提高手术优良率,减少C臂X线照射次数,促进术后恢复。

Objective To explore the clinical effect of spinal endoscopic interlaminar approach surgery in the treatment of lumbar disc herniation(LDH).Methods A total of 278 patients with LDH treated in Anyang Third People’s Hospital from October 2017 to October 2021 were selected as the research subjects.According to the random number table method,they were divided into control group(139 cases)and observation group(139 cases).The control group was treated with intervertebral foramen approach surgery,and the observation group was treated with spinal endoscopic interlaminar approach surgery.The operation and recovery indicators(operation time,C-arm X-ray irradiation times,postoperative bed rest time and hospitalization time)and the excellent and good rate of operation[judged according to the Oswestry disability index(ODI)questionnaire for lumbar spine]were compared between the two groups.The postoperative complications and recurrence were recorded and compared between the two groups.Results The operation time,postoperative bed rest time and hospitalization time in the observation group were shorter than those in the control group,and the X-ray irradiation times of C-arm were fewer than those in the control group(P<0.05).One month after operation,the excellent and good rate of the observation group was higher than that of the control group(P<0.05).There was no statistical difference in the incidence of postoperative complications and recurrence between the observation group and the control group(P>0.05).Conclusion Spinal endoscopic interlaminar approach surgery has significant effect in the treatment of LDH,which can shorten the operation time,improve the excellent and good rate of operation,reduce the times of C-arm X-ray irradiation and promote postoperative recovery.