经皮全可视脊柱内镜手术在钙化型腰椎间盘突出症中的应用

Clinical Effects of Percutaneous Total Visual Spinal Endoscopic Surgery in Calcified Lum-bar Disc Herniation

目的:探讨全可视经皮脊柱内镜下治疗钙化性腰椎间盘的安全性、有效性及手术技巧。方法:收集三二〇一医院脊柱外科2017年5月至2022年6月间的43例钙化型腰椎间盘突出症患者,局麻后采用,全可视内镜下行髓核摘除、钙化去除、减压手术。采用视觉模拟量表(visual analog scale, VAS)评分、Oswestry功能障碍指数(Oswestry disability index, ODI)和MacNab标准评估手术疗效。结果:患者术后平均随访18.3个月,术后各时间点腰腿痛VAS评分较术前均明显降低(P < 0.05);末次随访时,ODI由术前平均52.4%降至平均7.21% (P < 0.05),按MacNab标准评定疗效优良率97.5%。结论:根据钙化椎间盘的不同分型,采用有效的术前规划和相应的手术技巧在全可视经皮脊柱内镜下治疗钙化型腰椎间盘突出症安全有效。

Objective: To investigate the safety, efficacy and surgical skills of total visual percutaneous spinal endoscopic treatment of calcified lumbar discs. Methods: A total of 43 patients with calcified lumbar disc herniation from May 2017 to June 2022 in the Department of Spine Surgery of 3201 Hospital were collected, and after local anesthesia, they underwent nucleus pulposus removal, calcification removal, and decompression surgery under full visual endoscopy. Surgical efficacy was assessed using visual analog scale (VAS) scores, Oswestry disability index (ODI), and MacNab criteria. Re-sults: The average postoperative follow-up was 18.3 months, and the VAS score of low back and leg pain at all time points after surgery was significantly lower than that before surgery (P < 0.05). At the last follow-up, ODI decreased from a preoperative average of 52.4% to an average of 7.21% (P < 0.05), and the excellent efficacy rate according to MacNab criteria was 97.5%. Conclusion: According to the different types of calcified intervertebral discs, effective preoperative planning and corre-sponding surgical techniques are used to treat calcified lumbar disc herniation under full-view percutaneous spinal endoscopy.