经皮椎间孔镜与单侧双通道脊柱内镜治疗单节段腰椎间盘突出症的临床疗效分析

Clinical Efficacy Analysis of Percutaneous Intervertebral Foraminoscopy and Unilateral Dual-channel Spinal Endoscopy for the Treatment of Single-segment Lumbar Intervertebral Disc Herniation

目的研讨经皮椎间孔镜与单侧双通道脊柱内镜治疗单节段腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效。方法回顾性分析2019年1月—2022年6月经福建中医药大学附属人民医院确诊为单节段LDH的患者70例的临床资料,根据手术方式的不同完成病例分为两组,每组35例。对照组行单侧双通道脊柱内镜治疗,观察组行经皮椎间孔镜手术治疗,比较两组手术基础指标、手术前后腰腿痛症状、腰椎功能、手术优良率及并发症。结果观察组术中出血量、手术及术后住院时间均优于对照组,差异有统计学意义(t=7.194、3.389、5.882,P<0.001)。两组术后腰腿痛视觉模拟评分法得分、功能障碍指数得分对比,差异无统计学意义(t=0.276、1.330,P>0.05)。两组末次随访的手术优良率(97.14%vs 91.43%)、并发症发生率(11.43%vs 5.71%)对比,差异无统计学意义(χ^(2)=0.265、0.182,P>0.05)。结论经皮椎间孔镜手术对单节段LDH患者的治疗优良率、安全性、腰腿痛症状及腰椎功能改善作用与单侧双通道脊柱内镜基本相当,同时还具有较好的近期处理效果。

Objective To study the clinical efficacy of percutaneous intervertebral foramenoscopy and unilateral dual channel spinal endoscopy in the treatment of single-segment lumbar disc herniation(LDH).Methods The clinical data of 70 patients diagnosed with single-segment LDH in the Affiliated People's Hospital of Fujian University of Chinese Medicine from January 2019 to June 2022 were retrospectively analyzed,and the cases were divided into two groups according to different surgical methods,with 35 cases in each group.The control group was treated with unilateral double-channel spinal endoscopy,and the observation group was treated with percutaneous foraminal endoscopic surgery.The basic indexes of surgery,symptoms of lumbar pain before and after surgery,lumbar function,surgical good and good rate and complications were compared between the two groups.Results The intraoperative blood loss,operation and postoperative hospital stay in the observation group were better than those in the control group,and the differences were statistically significant(t=7.194,3.389,5.882,P<0.001).There was no statistically significant difference in Visual Analogue Scale score and Oswestry Disability index score between the two groups(t=0.276,1.330,P>0.05).There was no statistically significant difference in the rate of surgical excellence(97.14%vs 91.43%)and incidence of complications(11.43%vs 5.71%)between the two groups at the last follow-up(χ^(2)=0.265,0.182,P>0.05).Conclusion Percutaneous foraminal surgery for single-level LDH patients has the same therapeutic advantages,safety,symptoms of back and leg pain and improvement of lumbar function as unilateral two-channel spinal endoscopy,and also has a better short-term treatment effect.