PETD与PEID治疗钙化型腰椎间盘突出症的疗效及并发症

Efficacy and complications analysis of PETD and PEID in the treatment of calcified lumbar disc herniation

目的探讨经皮椎间孔入路椎间盘切除术(percutaneous endoscopic transforaminal discectomy,PETD)与经皮椎板间入路椎间盘切除术(percutaneous endoscopic interlaminar discectomy,PEID)治疗钙化型腰椎间盘突出症的疗效及并发症。方法回顾性分析2019年12月至2021年12月60例钙化型腰椎间盘突出症患者的临床资料。按照手术方式分为PETD组28例、PEID组32例。比较两组手术治疗情况、术后并发症发生情况。术后随访6个月,比较两组视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)变化,统计近期疗效。结果相较于PETD组,PEID组手术时间缩短,C型臂透视次数减少,髓核摘除量增加(P<0.05)。术后3d、3个月及6个月,两组VAS评分、ODI指数均低于入院时(P<0.05),组间比较差异无统计学意义(P>0.05)。PETD组治疗优良率为92.86%,PEID组为90.63%,差异无统计学意义(P>0.05)。PETD组并发症发生率为14.29%,PEID组为12.50%,差异无统计学意义(P>0.05)。结论PETD、PEID治疗钙化型腰椎间盘突出症均具有较好短期疗效,并发症少,相较于PETD,PEID手术时间更短、C型臂透视次数更少、髓核摘除量更多。

Objectivee To investigate the efficacy and complications of percutaneous endoscopic transforaminal discectomy(PETD)and percutaneous endoscopic interlaminar discectomy(PEID)in the treatment of calcified lumbar disc herniation.Methods A retrospective analysis of clinical data from 60 patients with calcified lumbar disc herniation treated at our hospital from December 2019 to December 2021 was performed.The patients were divided into two groups based on the surgical approach:PETD group(28 cases)and PEID group(32 cases).Surgical outcomes and postoperative complications were compared between the two groups.The patients were followed up for 6 months,and the changes in Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)scores were compared to evaluate short-term efficacy.Results Compared with the PETD group,the PEID group had shorter operative time,fewer fluoroscopic instances with C-arm,and greater nucleus pulposus removal(P<0.05).At 3 days,3 months,and 6 months postoperatively,VAS and ODI scores in both groups were significantly lower than at admission(P<0.05),with no statistically significant differences between the groups(P>0.05).The excellent and good rate was 92.86%in the PETD group and 90.63%in the PEID group,with no statistically significant difference(P>0.05).The complication rate was 14.29%in the PETD group and 12.50%in the PEID group,with no statistieally significant diference(P>0.05).Conclusion Both PETD and PEID provide good short-term efficacy and few complications for the treatment of calcified lumbar disc herniation.Compared with PETD,PEID has shorter operative time,fewer fluoroscopic instances with C-arm,and greater nucleus pulposus removal.