定位器辅助经皮椎间孔镜髓核摘除术治疗LDH的疗效观察

Effect of localizer-assisted percutaneous foraminal nucleus pulposectomy for LDH

目的:分析定位器辅助经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症(Lumbar disc herniation,LDH)的疗效。方法:选取2020年2月至2022年2月在我院接受治疗的121例LDH患者,以随机数字表法分为摘除术组(n=58)和定位器组(n=63),前组实施经皮椎间孔镜髓核摘除术,后组在其基础上增加定位器辅助手术。于手术前、手术2 m后观察并对比两组手术指标,采用视觉模拟评分(Visual analogue scale,VAS)评估疼痛程度、Oswestry功能障碍指数(The Oswestry Disability Index,ODI)评分评估腰椎功能,酶联免疫吸附法评估炎症介质水平,统计并对比治疗效果及术后并发症。结果:与摘除术组相比,定位器组手术指标更优(P<0.05);定位器组VAS、ODI评分,炎症介质水平,术后并发症总发生率较低(P<0.05),定位器组治疗总有效率较高(P<0.05)。结论:定位器辅助经皮椎间孔镜髓核摘除术治疗LDH创伤性较小,对腰椎功能的改善功能确切,近期疗效可靠。

Objective:To analyze the effect of localizer-assisted percutaneous transforaminal nucleus pulposectomy in the treatment of lumbar disc herniation(LDH).Methods:A total of 121 LDH patients who received treatment in our hospital from February 2020 to February 2022 were selected and divided into the enucleation group(n=58)and locator group(n=63)by random number table method.The former group underwent percutaneous interforaminal endoscopic enucleation of nucleus pulposus,and the latter group was supplemented with locator-assisted surgery.The surgical indexes of the two groups were observed and compared before and 2 m after surgery.Visual analogue scale(VAS)was used to evaluate the degree of pain and the Oswestry Disability Index(The Oswestry Disability Index,ODI)score was used to evaluate the lumbar function,enzyme-linked immunosorbent assay(ELISA)was used to evaluate the level of inflammatory mediators,and the therapeutic effect and postoperative complications were counted and compared.Results:Compared with the excision group,the operative indexes of the locator group were better(P<0.05).VAS and ODI scores,levels of inflammatory mediators,and total incidence of postoperative complications were lower in the locator group(P<0.05),while the total effective rate was higher in the locator group(P<0.05).Conclusion:Localizer-assisted percutaneous foraminal nucleus pulposectomy can effectively reduce intraoperative trauma in patients with LDH,improve lumbar function,have fewer postoperative complications,and have reliable short-term effects.