经皮椎间孔镜髓核摘除术治疗单节段钙化型腰椎间盘突出症的疗效观察

Percutaneous transforaminal endoscopic nucleus pulpectomy for single-segment calcified lumbar disc herniation

目的观察比较经皮椎间孔镜髓核摘除术及椎板开窗髓核摘除术治疗单节段钙化型腰椎间盘突出症的疗效。方法选择2015年3月—2018年3月在广西钦州市第二人民医院骨三科接受椎间孔镜髓核摘除术治疗的单节段钙化型腰椎间盘突出症患者50例作为观察组,同期在医院接受椎板开窗髓核摘除术治疗的单节段钙化型腰椎间盘突出症患者45例作为对照组。比较2组患者围手术情况、视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、血清肌红蛋白含量、腓总神经及胫神经的神经传导速度(NCV)的差异。结果观察组患者的手术时间、神经根过敏及表皮感染发生率与对照组比较差异无统计学意义(P>0.05),观察组患者术中出血量、术后引流量、术后VAS评分、ODI评分、血清肌红蛋白含量均明显低于对照组(t/P=19. 128/0.000,16. 397/0.000,20. 198/0. 000,8. 446/0.000,5.584/0.000),腓总神经及胫神经的NCV均明显高于对照组(t/P=2.223/0.029,2.588/0.011)。结论经皮椎间孔镜髓核摘除术治疗单节段钙化型腰椎间盘突出症的疗效优于椎板开窗髓核摘除术。

Objective To observe the curative effect of percutaneous transforaminal endoscopic nucleus pulposus removal and laminotomy for single-segment calcified lumbar disc herniation.Methods From March 2015 to March 2018,50 patients with single-segment calcified lumbar intervertebral disc herniation who underwent endoscopic discectomy in Orthopedics Department of Qinzhou Second People’s Hospital of Guangxi were selected as the observation group,while 45 patients with single-segment calcified lumbar disc herniation who underwent fenestration discectomy in hospital were selected as the control group.Perioperative conditions,visual analogue scale(VAS),Oswestry dysfunction index(ODI),serum myoglobin content,nerve conduction velocity(NCV)of common peroneal nerve and tibial nerve were compared between the two groups.Results There was no significant difference in the operation time,nerve root allergy and epidermal infection between the observation group and the control group(P>0.05).The intraoperative blood loss,postoperative drainage,postoperative VAS score and ODI score were observed in the observation group.The serum myoglobin content was significantly lower than that of the control group(t/P=19.128/0.000,t/P=16.397/0.000,t/P=20.198/0.000,t/P=8.446/0.000,t/P=5.584/0.000),NCV of common peroneal nerve and phrenic nerve were significantly higher than the control group(t/P=2.223/0.029,t/P=2.588/0.011).Conclusion Percutaneous transforaminal endoscopic nucleus pulpectomy for single-segment calcified lumbar disc herniation is superior to fenestration.