改良TESSYS技术对腰椎间盘突出症患者腰部活动度及脊柱稳定性的影响

Effects of modified TESSYS technology on waist mobility and spinal stability in patients with lumbar disc herniation

目的探讨改良经椎间孔脊柱内镜系统(TESSYS)技术对腰椎间盘突出症(LDH)患者腰部活动度及脊柱稳定性的影响。方法回顾性分析2019年2月至2022年2月疼痛科收治的110例LDH患者的临床资料,根据不同术式将患者分为对照组和研究组,各55例。对照组给予椎间盘镜技术治疗,研究组给予改良TESSYS技术治疗。比较两组患者的手术指标以及手术前、后的腰部活动度、脊柱稳定性及腰椎功能。结果研究组的切口长度小于对照组,手术时间、卧床时间及住院时间短于对照组,术中出血量少于对照组(P<0.05)。术后1个月,研究组的腰椎曲度、腰屈曲范围、腰背肌后伸活动度及腰背屈肌/伸肌比值(F/E)均显著优于对照组(P<0.05)。术后1个月,研究组的腰椎前凸角、腰骨倾斜角、矢状面平衡及颌眉角均显著优于对照组,差异具有统计学意义(P<0.05)。术后3个月,研究组的Roland-Morris功能障碍调查表(RMQ)、视觉模拟疼痛评分量表(VAS)评分低于对照组,日本骨科协会(JOA)评分高于对照组,腰椎关节活动度(ROM)大于对照组,差异具有统计学意义(P<0.05)。结论相较于椎间盘镜技术,改良TESSYS技术在LDH患者的治疗中更具优势,其创伤小,术中出血少,有利于改善腰部活动度,恢复脊柱稳定性,从而更好地改善腰椎功能,值得临床应用推广。

Objective To investigate the effects of modified transforaminal endoscopic spine system(TESSYS)technology on waist mobility and spinal stability in patients with lumbar disc herniation(LDH).Methods The clinical data of 110 patients with LDH admitted in the pain department from February 2019 to February 2022 were retrospectively analyzed.According to different operation methods,all patients were divided into control group and study group,with 55 cases in each group.The control group was treated with microendoscopy technology,and the study group was treated with modified TESSYS technology.The surgical indexes,waist mobility,spinal stability and lumbar function before and after surgery were compared between the two groups.Results The incision length of the study group was smaller than that of the control group,the surgery time,bed time and hospital stay were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).One month after surgery,the lumbar curvature,lumbar flexion range,posterior extension of lumbodorsi muscle and flexor/extensor(F/E)value of the study group were significantly better than those of the control group(P<0.05).One month after surgery,the lumbar lordosis angle,lumbar bone inclination angle,sagittal plane balance and maxilloeyebrow angle of the study group were significantly better than those of the control group,and the differences were statistically significant(P<0.05).Three months after surgery,the Roland-Morris Disability Questionnaire(RMQ)and Visual Analogue Scale(VAS)scores of the study group were lower than those of the control group,Japanese Orthopaedic Association(JOA)score was higher than that of the control group,range of motion(ROM)was greater than that of the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with microendoscopy technology,modified TESSYS technology has more advantages in the treatment of LDH patients,with less trauma and intraoperative bleeding,it is conducive to improving waist mol bility and restoring spinal stability,thus better improving lumbar function,which is worthy of clinical application and promotion.