[1]刘联群,陈长贤△,王汉龙,等.经皮侧路椎间孔镜与后路椎板开窗术治疗腰椎间盘突出症的中期疗效观察[J].中国中医骨伤科杂志,2017,25(05):30-33，37.
　LIU Lianqun CHEN Changxian WANG Hanlong WU Zhiqiang LAI Zhanlong KE Xiaobin WU Yifeng LIN Xiaoming WENG Wenshui.Mid-term Efficacy of Percutaneous Endoscopic Lumbar Discectomy and Fenestration Laminectomy Discectomy in the Treatment of Lumbar Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(05):30-33，37.
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经皮侧路椎间孔镜与后路椎板开窗术治疗腰椎间盘突出症的中期疗效观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年05期
页码:
30-33，37
栏目:
临床研究
出版日期:
2017-05-08

文章信息/Info

Title:
Mid-term Efficacy of Percutaneous Endoscopic Lumbar Discectomy and Fenestration Laminectomy Discectomy in the Treatment of Lumbar Disc Herniation
文章编号:
1005-0205(2017)05-0030-04
作者:
刘联群1;  陈长贤1△;  王汉龙1;  吴志强1;  赖展龙1;  柯晓斌1;  吴毅峰1;  林小明1;  翁文水1
1.福建省泉州市正骨医院(福建 泉州,362000)
△.通信作者 E-mail:ccx6070@qq.com
Author(s):
LIU Lianqun1 CHEN Changxian1△ WANG Hanlong1 WU Zhiqiang1 LAI Zhanlong1 KE Xiaobin1 WU Yifeng1 LIN Xiaoming1 WENG Wenshui1
1.Fujian Quanzhou Orthopedic Hospital, Quanzhou 362000, Fujian China.
关键词:
腰椎间盘突出症;  侧路椎间孔镜;  后路椎板开窗;  疗效
Keywords:
lumbar disc herniation;  percutaneous endoscopic lumbar discectomy;  fenestration laminectomy discectomy;  efficacy
分类号:
R681.5
文献标志码:
A
摘要:
目的:对比经皮侧路椎间孔镜(PELD)和传统后路椎板开窗髓核摘除术(FLD)治疗腰椎间盘突出症(LDH)的临床疗效、优缺点及适应证。方法:自2013年7月至2014年7月共100例单节段腰椎间盘突出症,采用经皮侧路椎间孔镜技术(孔镜组)50例,采用后路椎板开窗髓核摘除术(开窗组)50例。分别对两组的手术时间、术中出血量、切口长度、恢复原生活劳作时间、并发症进行比较; 术后随访按视觉模拟评分(VAS)、日本骨科协会(JOA)评分、Macnab疗效标准统计评价疗效。结果:PELD与FLD手术的优良率、并发症差异无统计学意义(P>0.05),而手术时间、术中出血量、切口长度、恢复原生活劳作时间差异有统计学意义(P<0.05)。结论:两种手术方式临床疗效相当,均是治疗LDH的有效方式,其各有优缺点:PELD具有医源性创伤小、出血少、术后患者恢复快、术后失败翻修相对简单、患者容易接受等优点,是现代微创外科的发展趋势,但其对术者技术要求较高; 而FLD创伤相对较大,术后恢复较慢,但其对术者技术要求较低、适应症宽,可作为PELD的有效补充。
Abstract:
Objective: To compare the clinical efficacy, advantages, disadvantages, and indications of percutaneous endoscopic lumbar discectomy(PELD)and traditional fenestration laminectomy discectomy(FLD)in the treatment of lumbar disc herniation. Methods: From July 2013 to July 2014, a total of 100 cases of single segment lumbar disc herniation were chosen, 50 cases in the hole group were managed with PELD, 50 cases in the window group were managed with FLD. The operative time, the intraoperative blood loss, the incision length, the time of recovering to original life and work, and the complications were compared and analyzed between the two groups. The efficacy was evaluated statistically by visual analogue score(VAS), Japanese orthopedic association(JOA)score and Macnab efficacy standard during the postoperative follow-up. Results: There were no significant differences in the excellent and good rate and the complications between PELD and FLD surgery, while there were statistically significant differences in the operative time, the intraoperative blood loss, the incision length and the time of recovering to original life. Conclusion: The clinical efficacy of two surgical methods is equal, both of them are effective ways to treat LDH, and each of them has its advantages and disadvantages: PELD has the advantages of less iatrogenic trauma, less bleeding, recovering faster after surgery, relatively simple postoperative refurbishment, easy acceptance of patients and so on, which is the development trend of modern minimally invasive surgery, but PELD has higher technical requirements for surgeon. While FLD trauma is relatively large and postoperative recovery is slower, but its technical requirements for the surgeon are lower, and it has a wide range of application, which can be used as an effective supplement for PELD.

参考文献/References:

[1] Tenenbaum S,Arzi H,Herman A,et al.Percutaneous Posterolateral Transforaminal Endoscopic Discectomy:Clinical Outcome,Complications,and Learning Curve Evaluation[J].Surg Technol Int,2011,21:278-283.
[2] 姚辉,徐义春,陈碧英,等.侧路经皮椎间孔镜技术在腰椎后路术后再次手术中的应用[J]中国骨伤,2015,28(8):712-716.
[3] Yeung AT,Tsou PM.Posterolateral endoscopic excision for lumbar disc herniation:surgical technique,outcome and complications in 307 consecutive cases[J].Spine(Phila Pa 1976),2002,27(7):722-731.
[4] Hoogland T,Schubert M,Miklitz B,et al.Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain:a prospective randomized study in 280 consecutive cases[J].Spine(Phila Pa 1976),2006,31(24):e890-e897.
[5] 赵学军,左玲,傅志剑,等.经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症[J].中国疼痛医学杂志,2013,19(1):568-571.
[6] 张之栋,杜怡斌,储建军.经皮椎间孔镜腰椎间盘摘除术与微创经椎间孔腰椎融合术治疗腰椎间盘突出症的前瞻性随机对照研究[J].中国微创外科杂志,2015,15(7):583-587.
[7] 周跃,李长青,王建,等.椎间孔镜YESS与TESSYS技术治疗腰椎间盘突出症[J].中国骨科杂志,2010,30(3):225-230.
[8] 石立刚 杨林 焦书敏,等.椎问孔镜治疗700例腰椎间盘突出症疗效的危险因素分析[J].实用医学杂志,2015,14(6):2337-2339.
[9] 吕宏,孔金海,钟南哲,等.经椎间孔入路经皮内窥镜下椎间盘切除术治疗腰椎椎间盘突出症[J].脊柱外科杂志,2015,13(6):373-376.
[10] 潘承波,刘法银,李嗣生.经皮椎间孔镜治疗腰椎间盘突出症的疗效观察.中国骨与关节损伤杂志,2015,30(1):94-95.
[11] 禤天航,刘效仿,曹正霖,等.经皮椎间孔镜与椎板开窗髓核摘除术治疗复发性腰椎间盘突出症的疗效比较[J].中国骨与关节损伤杂志,2016,31(9):972-974.
[12] 赵采花,汤逊,史志江,等.经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的疗效对比[J].中国疼痛医学杂志,2014,20(1):60-63.
[13] 丁伟国,徐卫星,卢笛,等.经皮椎间孔镜与开放椎板间开窗术治疗腰椎间盘突出症的疗效分析[J].中国内镜杂志,2016,22(4):43-48.
[14] 张德辉,李运芝,张智慧,等.椎间孔镜治疗有典型根性症状的腰椎手术失败综合征[J].中国微创外科杂志,2014,14(7):647-649.
[15] 唐国柯,黄庆华,张威.经皮椎间孔镜治疗老年腰椎间盘突出症的近、中期疗效分析[J].中国内镜杂志,2012,18(12):1300-1303.
[16] 赵杉,贺石生,张海龙.椎间孔镜术后感觉异常的危险因素及处理[J].实用骨科杂志,2014,20(11):1051-1052.
[17] 罗磊,柏光泽,罗江洪.应用侧后路椎间孔镜治疗中央型腰椎间盘突出症[J].实用骨科杂志,2013,19(12):1057-1060.
[18] 金钟,雷光虎,梁冰,等.经皮椎间孔镜治疗腰椎间盘突出症[J].中国疼痛医学杂志,2013,19(7):446-446.
[19] 郑拥军,叶乐,王祥瑞.经皮椎间孔镜技术治疗腰椎间盘突出症30例的近期疗效[J].上海医学,2012,35(6):473-475.

备注/Memo

备注/Memo:
基金项目:福建省泉州市科技项目(Z[2013]0269)
更新日期/Last Update: 2017-05-01