经皮椎间孔镜术治疗腰椎间盘突出症的近期疗效

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摘要目的观察经皮椎间孔镜术(pereutaneous transforaminal endoscopic discectomy,PTED)治疗腰椎间盘突出症的近期效果。方法 2013-03至2014-06采用PTED治疗腰椎间盘突出症患者104例,102例获得术后12个月随访。采用视觉模拟(visual analogue score,VAS)评价术前、术后2 d、术后6、12个月腰腿痛缓解情况,Oswestry功能障碍指数(Oswestry DisabiIity Index,ODI)评定和改良 MacNab标准,评价术后12个月临床疗效。结果 102例腰痛VAS评分术后2 d、术后6、12个月与术前(6.3±2.3)分相比差异有统计学意义(P<0.05)。腿痛VAS评分术后2 d、术后6、12个月与术前相比差异有统计学意义(P<0.05)。ODI指数由术前(69.3±15.2)降为术后12个月随访的(11.2±2.3),差异有统计学意义(P<0.05)。根据改良MacNab疗效评定优51例,良46例,可2例,差3例。术后优良率为95.10%。2例术后复发行切开手术。结论 PTED治疗腰椎间盘突出症创伤小、恢复快,疗效可靠。

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关键词 ：腰椎, 椎间盘移位, 椎间孔镜, 近期疗效

Abstract：Objective To observe the preliminary outcomes of percutaneous transforaminal endoscopic discectomy(PTED) in lumbar disc herniation.Methods From March 2013 to June 2014,104 patients with lumbar disc herniation were treated with PTED.A total of 102 cases,64 males and 38 females,aged from 17 to 72 years,averaged(52.3±16.4)years were followed up for 12 months.Using the visual analogue score( VAS),we evaluated preoperatively, 2 days after operation, 6 months and 12 months after postoperative lumbocrural pain relief.Oswestry DisabiIity Index(ODI) and improved MacNab criteria were observed at the time of the preoperation and 12 months postoperation to assess the clinical efficacy.Results 102 patients were followed up for 12 months.The back pain scores before and after treatment,at 2 days,6 and 12 months after treatment and at the final follow-up were kept,respectively.The leg pain scores before and after treatment,at 2 days,6 and 12 months after treatment and at the final follow-up were kept,respectively. All there scores increased significantly compared with their preoperative ones (P<0.01).The 12 months postoperative follow-up ODI indexwas(11.2±2.3) , lower than the preoperative(68.8 114.6), (P<0.01).According to modified MacNab criteria for grading Results,95.1％ of these patients had excellent and good outcomes at 12 months after treatment.Two patients had recurrenceafter operation and underwent open operation.Conclusions PTED is an effective treatment method for lumbar disc herniation and its preliminary efficacy is reliable.

Key words： lumbar vertebrae intervertebral disk displacement transforanfinal endoscopy preliminary effectiveness

收稿日期: 2015-09-13

ZTFLH:

R681.53

基金资助:嘉兴市科技计划项目(SQ2014010451)

通讯作者: 吴宏飞, E-mail:15957351817@163.com

作者简介: 张玉良,本科学历,副主任医师。

引用本文:

张玉良, 吴宏飞. 经皮椎间孔镜术治疗腰椎间盘突出症的近期疗效[J]. 武警医学, 2016, 27(4): 370-372. ZHANG Yuliang and WU Hongfei. Preliminary outcomes of percutaneous transforaminal endoscopy in treatment of lumbar disc herniation. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(4): 370-372.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2016/V27/I4/370

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