[1]李大刚,陈世忠△,郑景陆.透视下经皮腰椎内镜手术中分级椎间孔成形方法及临床应用[J].中国中医骨伤科杂志,2024,32(11):63-66+71.[doi:10.20085/j.cnki.issn1005-0205.241112]
　LI Dagang,CHEN Shizhong,ZHENG Jinglu.Research on the Graded Foraminoplasty Method and Clinical Application in Percutaneous Lumbar Endoscopic Surgery under Fluoroscopy[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(11):63-66+71.[doi:10.20085/j.cnki.issn1005-0205.241112]
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透视下经皮腰椎内镜手术中分级椎间孔成形方法及临床应用()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年11期
页码:
63-66+71
栏目:
临床报道
出版日期:
2024-11-15

文章信息/Info

Title:
Research on the Graded Foraminoplasty Method and Clinical Application in Percutaneous Lumbar Endoscopic Surgery under Fluoroscopy
文章编号:
1005-0205(2024)11-0063-04
作者:
李大刚1; 陈世忠1△; 郑景陆1
1中山市中医院(广东 中山,528400)
Author(s):
LI Dagang1; CHEN Shizhong1△; ZHENG Jinglu1
1Zhongshan Hospital of Chinese Medicine,Zhongshan 528400,Guangdong China.
关键词:
腰椎间盘突出症;  经皮内镜;  椎间孔成形;  分级
Keywords:
lumbar disc herniation;  pereutaneous discectomy endoscopic;  foraminoplasty;  grade
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.241112
文献标志码:
B
摘要:
目的:介绍透视下经皮腰椎内镜手术中分级椎间孔成形的方法及临床应用。方法:2020年8月至2023年12月,应用透视辅助下经皮腰椎内镜治疗腰椎间盘突出症患者198例,术后均磁共振或CT复查,根据椎间孔成形程度不同,分为Ⅰ度、Ⅱ度及Ⅲ度成形组,对比分析三组的性别、年龄、伴有椎间盘钙化情况、术前Oswestry功能障碍指数(ODI)评分、术后ODI评分、术前腰椎视觉模拟量表(VAS)评分、术后腰椎VAS评分、术前下肢VAS评分、术后下肢VAS评分、术后复发、术后残留、神经硬膜囊损伤及术中出血等情况。结果:Ⅰ度成形组共32例,全部为单纯椎间盘突出病例,伴有椎间盘钙化患者2例,早期效果均优良; 术后复发2例,术后残留1例,无神经硬膜损伤,无术中大出血发生。Ⅱ度成形组共103例,伴有椎间盘钙化患者6例,伴有侧隐窝狭窄患者15例,早期效果均优良; 术后复发5例,术后残留2例,无神经硬膜损伤,无术中大出血发生。Ⅲ度成形组共63例,伴有椎间盘钙化患者3例,伴有侧隐窝狭窄患者17例,伴有椎管狭窄患者12例,早期效果均优良; 术后复发3例,术后残留1例,无神经硬膜损伤,无术中大出血患者。三组对比分析,性别、伴有椎间盘钙化情况、术前ODI评分、术后ODI评分、术前腰VAS评分、术前下肢VAS评分、术后下肢VAS评分、术后复发、术后残留、神经硬膜囊损伤及术中出血等情况差异均无统计学意义(P>0.05),年龄及术后腰椎VAS评分差异有统计学意义(P<0.05)。结论:通过控制椎间孔成形外套管的位置,可实现分级椎间孔成形。从本组病例来看,年龄越大,则需要的椎间孔成形也越大,术后腰痛VAS评分也越高。
Abstract:
Objective:To introduce the graded foraminoplasty method and clinical application in percutaneous endoscopic lumbar surgery under fluoroscopy.Methods:From August 2020 to December 2023,198 patients with lumbar disc herniation were treated with percutaneous lumbar endoscopic surgery under fluoroscopic assistance.Postoperatively,all patients underwent MRI or CT re-examinations.According to the degree of intervertebral foramen plasty,the patients were divided into grade Ⅰ,grade Ⅱ,and Grade Ⅲ formation groups.The gender,age,calcification of intervertebral disc,preoperative Oswestry disability index(ODI)score,postoperative ODI score,preoperative lumbar visual analogue scale(VAS)score,postoperative lumbar VAS score,preoperative lower limb VAS score,postoperative lower limb VAS score,postoperative recurrence,postoperative residue,nerve dura injury and intraoperative bleeding of the three groups were compared and analyzed.Results:In the grade Ⅰ plasty group,there were 32 cases,all of which were simple cases of disc herniation,2 cases of patients with disc calcification,and the early effect was excellent.There were 2 cases of postoperative recurrence,1 case of postoperative residual,no nerve dura injury,and no intraoperative bleeding.There were 103 patients in the grade Ⅱ plasty group,including 6 patients with intervertebral disc calcification,15 patients with lateral recess stenosis.The early results were excellent.There were 5 cases of postoperative recurrence,2 cases of postoperative residual,no nerve dura injury,no intraoperative bleeding.There were 63 patients in the grade Ⅲ plasty group,including 3 patients with disc calcification,17 patients with lateral recess stenosis,and 12 patients with spinal canal stenosis.The early effects were excellent.There were 3 cases of postoperative recurrence,1 case of postoperative residual,no nerve dura injury,and no patients with intraoperative bleeding.There were no significant differences in gender,calcification of intervertebral disc,preoperative ODI score,postoperative ODI score,preoperative lumbar VAS score,preoperative lower limb VAS score,postoperative lower limb VAS score,postoperative recurrence,postoperative residue,nerve dura injury and intraoperative bleeding among the three groups,but there were significant differences in age and postoperative lumbar VAS score.Conclusion:Graded foraminoplasty can be achieved by controlling the position of the forming outer tube.For the older cases,the larger foraminoplasty required,while the higher the postoperative lumbar VAS score.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:中山市社会公益科技研究项目(2021B1050)
△通信作者 E-mail:zsortho@163.com
更新日期/Last Update: 2024-11-05