不同入路全脊柱内镜下手术对腰椎间盘突出症合并糖尿病患者手术情况及临床疗效影响

Effects of Endoscopic Spinal Surgery via Different Approaches on Surgical Indexes and Clinical Efficacy in Patients with Lumbar Disc Herniation Complicating Diabetes

目的探究不同入路全脊柱内镜下手术对腰椎间盘突出症合并糖尿病患者手术情况及临床疗效影响。方法选取我院2020年1月~2021年12月脊柱外科收治的102例腰椎间盘突出症合并糖尿病患者为研究对象。采用随机分组法分为观察组与对照组,两组各51例患者。对照组椎板间入路,观察组采用椎间孔入路。观察两组患者围术期情况与手术后疼痛情况、脊柱稳定性及手术应激指标。结果两组患者住院时间、切口长度无差异(P>0.05)。观察组手术时间显著少于对照组(P<0.05)。两组患者术后VAS评分无差异(P>0.05)。两组患者术后脊柱稳定性腰椎前凸角、胸椎后凸角、矢状面平衡无差异(P>0.05)。两组患者术后GSH-Px、SOD、MDA水平无差异(P>0.05)。结论不同入路全脊柱内镜下手术能有效降低腰椎间盘突出症合并糖尿病患者住院时间及缩短手术时间,能有效降低疼痛度与改善手术应激指标。

Objective To discuss the effects of endoscopic spinal surgery via different approaches on surgical indexes and clinical efficacy in patients with lumbar disc herniation complicating diabetes.Methods A sample of 102 patients with lumbar disc herniation complicating diabetes underwent endoscopic lumbar discectomy in our hospital from January 2020 to December 2021 were enrolled,and randomly divided into two groups,each with 51 cases.Control group received surgery via percutaneous endoscopic interlaminar lumbar discectomy,and observation group received percutaneous endoscopic transforaminal lumbar discectomy.Then the perioperative indexes,postoperative pain,segmental stability and surgical stress were compared between groups.Results The hospital stay length and incision length yielded no statistical difference between two groups(P>0.05),while the operation time was significantly shorted in observation group compare with control group(P<0.05).The postoperative Visual Analogue Scale(VAS)score showed no statistical difference between groups(P>0.05).The parameters including thoracic kyphosis(TK),lumbar lordosis(LL)and sagittal vertical axis(SVA)after operation yielded no statistical difference between groups(P>0.05).No statistical difference was found in the postoperative levels of glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),and malondialchehyche(MDA)between two groups(P>0.05).Conclusion Application of percutaneous endoscopic lumbar discectomy via different approaches for patients with lumbar disc herniation complicating diabetes can effectively shorten the hospital stay length and operation time,attenuate the pain degree and ameliorate the surgical stress parameters.