椎间孔镜下腰椎间盘髓核摘除联合纤维环缝合修复对腰椎间盘突出症的效果

Effect of Intervertebral Foramen Endoscopic Lumbar Disc Nucleus Pulposus Removal Combined with Fiber Ring Suture Repair on Lumbar Disc Herniation

目的:本文主要探究经赣南医学院第二附属医院相关检查明确为腰椎间盘突出症的患者,临床给予椎间孔镜下腰椎间盘髓核摘除联合纤维环缝合修复治疗的可行性。方法:选取2020年11月—2022年11月赣南医学院第二附属医院医治的腰椎间盘突出症患者68例作为研究对象,根据电脑随机法将其分成对照组和观察组,各34例。对照组采取腰椎小开窗手术治疗,观察组采取椎间孔镜下腰椎间盘髓核摘除联合纤维环缝合修复治疗。比较两组术前术后疼痛因子水平、腰部活动度、脊柱稳定性的差异。结果:两组术前疼痛因子水平比较,差异均无统计学意义(P>0.05)。两组术后3个月β-内啡肽、前列腺素E2、5-羟色胺水平等疼痛因子水平均低于本组术前,差异均有统计学意义(P<0.05);观察组术后3个月β-内啡肽、前列腺素E2、5-羟色胺水平等疼痛因子水平均低于对照组,差异均有统计学意义(P<0.05)。两组术前腰部活动度比较,差异均无统计学意义(P>0.05)。两组术后3个月腰椎后伸、腰椎前屈、腰椎左侧屈、腰椎右侧屈等腰部活动度均高于本组术前,差异均有统计学意义(P<0.05);观察组术后3个月腰椎后伸、腰椎前屈、腰椎左侧屈、腰椎右侧屈等腰部活动度均高于对照组,差异均有统计学意义(P<0.05)。两组术前脊柱稳定性比较,差异均无统计学意义(P>0.50)。两组术后3个月胸椎后凸角均高于本组术前,腰椎前凸角、矢状面平衡、颌眉角均低于本组术前,差异均有统计学意义(P<0.05);观察组术后3个月胸椎后凸角高于对照组,腰椎前凸角、矢状面平衡、颌眉角均低于对照组,差异均有统计学意义(P<0.05)。结论:对于存在腰椎间盘突出症的患者,临床给予椎间孔镜下腰椎间盘髓核摘除联合纤维环缝合修复效果显著,该方案不仅能够改善腰椎间盘突出症患者疼痛情况及腰部活动度,还有助于恢复脊柱的稳定性,为广大腰椎间盘突出症患者提供了更加精准、高效的治疗新选择。

Objective:To explore the feasibility of clinical treatment of lumbar disc herniation by intervertebral foramen endoscopic lumbar disc nucleus pulposus removal combined with fiber ring suture repair for patients who were confirmed to be lumbar disc herniation by relevant examinations of the Second Affiliated Hospital of Gannan Medical College.Method:A total of 68 patients with lumbar disc herniation treated in the Second Affiliated Hospital of Gannan Medical College from November 2020 to November 2022 were selected as the subjects of this study,and they were divided into the control group and the observation group according to the differences in treatment schemes,with 34 cases in each group.The control group was treated with small fenestration of the lumbar spine,and the observation group was treated with intervertebral foramen endoscopic lumbar disc nucleus pulposus removal and fiber ring suture repair.The differences in preoperative and postoperative pain factor levels,lumbar range of motion,and spinal stability between the two groups were compared.Result:There were no statistically significant differences in preoperative pain factor levels between the two groups(P>0.05).The levels of pain factors such asβ-endorphin,prostaglandin E2 and 5-hydroxytryptamine in the two groups at 3 months after operation were lower than those before operation,the differences were statistically significant(P<0.05).The levels of pain factors such asβ-endorphin,prostaglandin E2 and 5-hydroxytryptamine at 3 months after operation in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in preoperative lumbar mobility between the two groups(P>0.05).The lumbar extension,lumbar forward flexion,left lumbar flexion,and right lumbar flexion of the two groups of patients at 3 months after operation were all higher than those before the surgery,the differences were statistically significant(P<0.05);the lumbar extension,lumbar forward flexion,left lumbar flexion,and right lumbar flexion in the observation group at 3 months after operation were all higher than those in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in preoperative spinal stability between the two groups(P>0.05).The thoracic kyphosis angle of the two groups at 3 months after operation were higher than those of the two groups before operation,and lumbar kyphosis angle,sagittal plane balance,and jaw brow angle at 3 months after operation were lower than those of the two groups before operation,with statistically significant differences(P<0.05);thoracic kyphosis angle at 3 months after operation in the observation group was higher than that in the control group,and lumbar kyphosis angle,sagittal plane balance,and jaw brow angle at 3 months after operation were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion:For patients with lumbar disc herniation,the clinical effect of intervertebral foramen endoscopic lumbar disc nucleus pulposus removal combined with fiber ring suture repair is significant.This scheme can not only improve the pain and lumbar mobility of patients with lumbar disc herniation,but also help restore the stability of the spine,providing more accurate and efficient treatment options for patients with lumbar disc herniation.