经皮椎间孔镜腰椎间盘切除术在腰椎间盘突出症中的应用价值及对患者腰椎功能的影响

Application value of percutaneous transforaminal endoscopic lumbar discectomy in lumbar disc herniation and its influence on lumbar function of patients

目的探讨经皮椎间孔镜腰椎间盘切除术在腰椎间盘突出症中的应用价值及对患者腰椎功能的影响。方法选取我院2021年1月至2023年1月收治的70例腰椎间盘突出症患者为研究对象。采用交替分组法将患者分为两组,观察组(35例)采用经皮椎间孔镜腰椎间盘切除术治疗,对照组(35例)采用椎板开窗术治疗。观察两组患者术中情况、住院时间及并发症发生率,比较两组患者术前及术后不同时间点的视觉模拟疼痛(VAS)评分、Oswestry功能障碍指数(ODI)、日本骨科协会评分(JOA)。结果与对照组比较,观察组患者术中出血量显著较少,手术时间及住院时间显著较短(P<0.05);术后两组各时间点VAS评分均低于术前,且观察组术后各时间点VAS评分显著低于对照组(P<0.05);术后两组各时间点ODI评分均低于术前,且观察组术后各时间点ODI评分显著低于对照组(P<0.05);术后两组各时间点JOA评分均高于术前,且观察组术后各时间点JOA评分显著高于对照组(P<0.05);两组患者并发症发生率比较差异无统计学意义(P>0.05)。结论经皮椎间孔镜腰椎间盘切除术可明显减轻腰椎间盘突出症患者的疼痛,有利于腰椎功能的恢复,安全性高。

Objective To explore the application value of percutaneous transforaminal endoscopic lumbar discectomy in lumbar disc herniation and its influence on patients'lumbar function.Methods 70 cases of lumbar disc herniation in our hospital from January 2021 to January 2023 were selected as the research object.Patients were divided into two groups by alternate grouping method.The observation group(35 cases)was treated by percutaneous intervertebral foramen endoscopic lumbar discectomy,while the control group(35 cases)was treated by laminectomy.The intraoperative situation,hospitalization time,and complication rate of the two groups were observed,and the visual simulated pain(VAS)score,Oswestry dysfunction index(ODI),and Japanese Orthopedic Association score(JOA)of the two groups were compared at different time points before and after the operation.Results The blood loss,operation time,and hospitalization time in the observation group were significantly lower than those in the control group(P<0.05).The VAS scores in both groups were lower than those before the operation,and the VAS scores in the observation group were significantly lower than those in the control group(P<0.05).After the operation,the ODI scores in both groups were lower than those before the operation,and the ODI scores in the observation group were significantly lower than those in the control group(P<0.05).The JOA scores in both groups were higher than those before the operation,and the JOA scores in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Percutaneous transforaminal endoscopic lumbar discectomy can obviously relieve the pain of patients with lumbar disc herniation,which is beneficial to the recovery of lumbar function and has high safety.