经皮内镜椎板间开窗椎间盘切除术治疗腰椎间盘突出症的疗效

Efficacy and safety of percutaneous endoscopic fenestration discectomy for lumbar disc herniation

目的:探讨经皮内镜椎板间开窗椎间盘切除术治疗腰椎间盘突出症的疗效及安全性。方法:将我院2019-02~2021-02收治的80例腰椎间盘突出症患者按随机数字表法分为对照组和观察组,各40例,给予对照组患者经皮内镜椎间孔入路椎间盘切除术治疗,给予观察组患者经皮内镜椎板间开窗椎间盘切除术治疗,比较两组患者手术时间、术中出血量、术中透视次数等手术指标,术前、术后1个月、末次随访的疼痛评分、功能障碍指数以及治疗效果。结果:两组患者术中出血量、住院时间、术后卧床时间、手术并发症发生率差异无统计学意义(P>0.05),观察组患者手术时间短于对照组患者,术中透视次数多于对照组患者(P<0.05),与手术前相比,手术后1个月、末次随访两组患者视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)评分均降低(P<0.05),两组比较差异无统计学意义(P>0.05),两组患者治疗效果差异无统计学意义(P>0.05)。结论:经皮内镜椎间孔入路椎间盘切除术和椎板间开窗椎间盘切除术均可改善腰椎间盘突出症患者临床症状及腰椎功能,椎板间开窗椎间盘切除术的手术时间较短,操作较方便。

Objective:To efficacy and safety of percutaneous endoscopic fenestration discectomy for lumbar disc herniation. Method:80 patients with lumbar disc herniation in our hospital from February 2019 to February 2021 were randomly divided into control group and observation group, 40 cases in each group. The control group was given percutaneous endoscopic transforaminal discectomy, while the observation group was given percutaneous endoscopic transforaminal fenestration discectomy Intraoperative fluoroscopy times and other surgical indicators, preoperative, postoperative 1 month, the last follow-up pain score and dysfunction index and treatment effect. Results: There was no significant difference in intraoperative blood loss, hospitalization time, postoperative bed time and the incidence of surgical complications between the two groups(P>0.05). The operation time of the observation group was shorter than that of the control group, and the number of intraoperative fluoroscopy was more than that of the control group(P<0.05), Compared with before surgery, visual analogue scale(VAS) and Oswestry disability index(ODI) scores were decreased in both groups at 1 month after surgery and at the last follow-up(P<0.05), there was no significant difference between the two groups(P>0.05), and there was no significant difference in the treatment effect between the two groups(P>0.05). Conclusion: Percutaneous endoscopic transforaminal discectomy and interlaminar fenestration discectomy can improve the clinical symptoms and lumbar function of patients with lumbar disc herniation. The operation time of interlaminar fenestration discectomy is shorter and the operation is more convenient.