椎间孔镜治疗Ⅲ型腰椎椎体后缘离断症的近期疗效研究

Study on the Short-term Effects of Foraminal Lens in the Treatment of Lumbar Disc Herniation with TypeⅢPosterior Ring Apophysis Fracture

目的分析经皮椎间孔镜治疗Ⅲ型腰椎椎体后缘离断症的近期临床疗效。方法回顾性分析2018-09/2021-09月在作者医院骨科行微创椎间孔入路治疗的Ⅲ型腰椎椎体后缘离断症患者资料23例。采用腰、腿痛视觉模拟评分(visual analogue scale,VAS),Oswestry功能障碍指数(Oswestry disability index,ODI)于术前和术后1、6、12个月时对患者症状及功能作出评估。12个月采用MacNab标准评定疗效。结果23例患者术后无感染、神经损伤等并发症发生;随访患者的VAS(腿痛)、VAS(腰痛)由术前(7.2±1.2)分、(3.7±1.1)分降至术后12个月(1.5±0.5)分、(2.1±0.3)分,ODI由术前(75.4±6.3)分降至(21.9±2.4)分,治疗前后比较差异具有统计学意义(P<0.05),末次随访改良MacNab标准评定疗效:优14例,良7例,可1例,差1例,优良率达91.30%。结论经皮椎间孔治疗腰椎后缘离断症近期疗效确切,具有损伤小,手术时间短,术后恢复快等优势。

Objective To analyze the short-term clinical effects of percutaneous foraminal lens in the treatment of lumbar disc herniation with typeⅢposterior ring apophysis fracture.Methods A retrospective analysis was performed on 23 patients with lumbar disc herniation with typeⅢposterior ring apophysis fracture treated by minimally invasive foraminal approach in department of orthopedics in author′s hospital from September 2018 to September 2021.Perioperative data were recorded.The visual analogue scale(VAS)and Oswestry disability index(ODI)were used to evaluate the symptoms and function of patients before surgery and at 1,6 and 12 months after surgery.The efficacy was evaluated by MacNab criteria at 12 months.Results There were no postoperative complications such as infection and nerve injury in 23 patients;the VAS(leg pain)and VAS(low back pain)decreased from(7.2±1.2)and(3.7±1.1)score before surgery to(1.5±0.5)and(2.1±0.3)score at 12 months after surgery,and the ODI decreased from(75.4±6.3)before surgery to(21.9±2.4)at 12 months before surgery,and the difference was statistically significant(P<0.05).According to the modified MacNab criteria,the results were excellent in 14 cases,good in 7 cases,fair in 1 case and poor in 1 case,with an excellent and good rate of 91.30%.Conclusion Percutaneous foraminal treatment of lumbar posterior margin amputation has the advantages of less injury,short operation time and quick postoperative recovery.