椎间孔镜经横突间入路治疗L_(5)-S_(1)椎间孔外型腰椎间盘突出症的临床研究

Clinical study of discectomy of extraforaminal lumbar disc herniation through intertransverse processes by percutaneous endoscope

目的探讨椎间孔镜经横突间入路治疗L_(5)-S_(1)椎间孔外型腰椎间盘突出症的可行性及临床疗效。方法本组共12例患者,其中男7例,女5例,年龄56~72岁,平均58.5岁,均行椎间孔镜经横突间入路髓核摘除,采用腰腿痛VAS评分评价手术疗效,末次随访时采用改良MacNab标准评价手术优良率。结果12例患者手术均顺利完成,术后随访9~18个月,平均12.5个月。所有患者腰痛、腿痛VAS评分均较术前明显降低,术后随访与术前比较差异均有显著性(P<0.01)。末次随访时采用改良MacNab评定标准评估疗效,术后优良率为91.67%。结论椎间孔镜经横突间入路治疗L_(5)-S_(1)椎间孔外型腰椎间盘突出症,操作性好、手术创伤小,临床疗效确切。

Objective To investigate the feasibility and clinical effect of discectomy of extraforaminal lumbar disc herniation through intertransverse processes by percutaneous endoscope.Methods A total of 12 cases of extraforaminal lumbar disc herniation patients were selected in this study,including 7 males,5 females,aged 56~72 years old,average 58.5 years old.All patients underwent discectomy through intertransverse processes by percutaneous endoscope.The clinical effect was evaluated by visual analogue score(VAS)at preoperation and postoperation,the surgical excellent and good rate was evaluated by the modified MacNab criteria at the last follow-up.Results All 12 patients were successfully completed the surgery,followed up 9 to 18 months after surgery,average 12.5 months.All patients,VAS score of low back and leg pain decreased after operation,which showed significant difference between preoperation and postoperation(P<0.01).At the last follow-up,the modified MacNab criteria was used to evaluate the efficacy,the excellent and good rate was 91.67%.Conclusion Discectomy of extraforaminal lumbar disc herniation through intertransverse processes by percutaneous endoscope is feasible.The operation has less trauma and definite clinical effect.