终板炎与经皮椎间孔镜腰椎髓核摘除术后早期再突出的相关性研究

Study on the Relationship between Modic Change and Early Re-Protrusion after Percutaneous Endoscopic Lumbar Discectomy

目的:初步探讨终板炎对经皮椎间孔镜治疗腰椎间盘突出症术后复发的影响。方法:选取2018年1月至2021年4月197例经皮椎间孔镜治疗腰椎间盘突出症在术前是否合并Modic改变的患者,通过两组患者在术后6个月内手术节段是否再突出的数量比例进行回顾性分析。结果:合并Modic改变的患者共60例,术后6个月内再突出患者8例,其中手术间隙L_(4~5)复发6例,L_(5)S_(1)复发2例,复发率为13.33%;不伴Modic改变的患者共137例,术后6个月内再突出患者共2例,其中手术间隙为L_(4~5)复发1例,L_(5)S_(1)复发1例,复发率为1.46%,差异有统计学意义(P<0.05)。结论:腰椎间盘突出合并终板炎为经皮椎间孔镜下腰椎髓核摘除术(PELD)术后早期再突出的危险因素之一。

Objective:To discuss the efficacy of modic changes on the recurrence of lumbar disc herniation after percutaneous transforaminal endoscopy preliminary.Methods:197cases of patients with lumbar disc herniation treated by percutaneous foraminal microscopy preoperative with or without modic changes from January 2018to April 2021were retrospectively analyzed in two groups through the proportion of re-protrusion within 6months after surgery.Results:A total of 60patients with modic changes,and 8 patients were re-prominent within 6months after surgery including 6patients with L4~5recurrence and 2patient with L5S1recurrence,with a recurrence rate of 13.33%(P<0.05).A total of 137patients without modic changes,and there were 2patients with re-protrusion within 6months after surgery including 1person with L4~5recurrence and 1person with L5S1recurrence,with a recurrence rate of 1.46%(P<0.05).Conclusion:Lumbar disc herniation combined with modic change is one of the risk factors for early re-protrusion after percutaneous endoscopic lumbar discectomy(PELD).