双针技术治疗腰椎间盘突出症的临床疗效研究

Study on clinical efficacy of bi-needle technique in the treatment of lumbar disc herniation

目的 比较双针技术与经皮椎间孔内窥镜脊柱系统(TESSYS)技术治疗腰椎间盘突出症的临床疗效。方法 回顾性分析61例行单节段经皮内镜下腰椎间盘髓核摘除术的腰椎间盘突出症患者的临床资料,按照随机数字表法将患者分为双针法组(28例)和TESSYS组(33例)。双针法组采用双针技术治疗, TESSYS组采用TESSYS技术治疗。比较两组术后日本骨科协会评估治疗分数(JOA评分)及视觉模拟评分法(VAS)评分、手术时间及术中透视时间。结果 61例患者均顺利完成手术,术后症状均有明显改善。手术前后两组组间VAS评分、JOA评分比较差异无统计学意义(P>0.05)。术后即刻双针法组、TESSYS组VAS评分分别为(2.1±1.1)、(2.0±1.1)分,均低于术前的(7.5±1.1)、(7.1±1.3)分, JOA评分分别为(25.4±2.3)、(25.0±1.8)分,均高于术前的(11.1±1.6)、(10.9±1.5)分,差异有统计意义(P<0.05)。双针法组手术时间为(96.8±9.3)min,术中透视时间为(9.9±1.4)s,均短于TESSYS组的(113.8±9.3)min、(13.0±1.6)s,差异有统计学意义(P<0.05)。结论 结合同轴脊柱内镜操作系统(YESS)技术和TESSYS技术的双针技术能显著缩短手术时间,减少术中透视时间,使患者及术者双双获益。

Objective To compare the clinical efficacy of bi-needle technique and transforaminal endoscopic spine system(TESSYS) in the treatment of lumbar disc herniation. Methods The clinical data of 61 patients with lumbar disc herniation who underwent single segment percutaneous endoscopic lumbar discectomy was retrospectively analyzed. All patients were divided into double needle group(28 cases) and TESSYS group(33 cases) according to random numerical table. The double needle group was treated with double needle technique, and the TESSYS group was treated with TESSYS technique. The Japanese Orthopaedic Association(JOA) score, visual analogue scale(VAS) score, operation time and intraoperative fluoroscopy time were compared between the two groups. Results All 61 patients completed the surgery successfully, and all had significant improvement in symptoms after surgery. There was no statistically significant difference in VAS scores and JOA scores between the two groups before and after surgery(P>0.05). Immediately after surgery, the VAS scores of double needle group and TESSYS group were(2.1±1.1) and(2.0±1.1) points, which were lower than(7.5±1.1)and(7.1±1.3) points of this group before surgery;the JOA scores of double needle group and TESSYS group were(25.4±2.3) and(25.0±1.8) points, which were higher than(11.1±1.6) and(10.9±1.5) points of this group before surgery;and the differences were statistically significant(P<0.05). The operation time of the double-needle group was(96.8±9.3) min and the intraoperative fluoroscopy time was(9.9±1.4) s, which were shorter than(113.8±9.3) min and(13.0±1.6) s of TESSYS group, and the differences were statistically significant(P<0.05).Conclusion The double needle technique combining Yeung Endoscopy Spine System(YESS) technology and TESSYS technology can significantly shorten the operation time, reduce the intraoperative fluoroscopy time, and benefit both patients and operators.