[1]李涛 张同会 吴从俊 李莹 谢维 刘鏐 唐谨 李俊杰 陈思 李绪贵△.椎间孔入路与椎板间入路椎间孔镜治疗腰5/骶1椎间盘突出症66例[J].中国中医骨伤科杂志,2020,28(05):84-88.
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椎间孔入路与椎板间入路椎间孔镜治疗腰5/骶1椎间盘突出症66例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年05期
页码:
84-88
栏目:
临床报道
出版日期:
2020-05-10

文章信息/Info

文章编号:
1005-0205(2020)05-0084-05
作者:
李涛1 张同会1 吴从俊1 李莹1 谢维1 刘鏐1 唐谨1 李俊杰1 陈思1 李绪贵1△
1湖北六七二中西医结合骨科医院(武汉,430079)
关键词:
椎间孔入路 椎板间入路 椎间孔镜 腰椎间盘突出症
分类号:
R681.5
文献标志码:
B
摘要:
目的:观察运用经皮内窥镜下经椎间孔入路与椎板间入路治疗腰5/骶1椎间盘突出症(LDH)的临床疗效。方法:回顾性分析2017年1月至2018年1月行椎间孔镜手术治疗的66例腰5/骶1椎间盘突出症患者,依据接受手术方式不同分为PETD和PEID两组。其中PETD组35例,男20例,女15例; 年龄31~75岁,平均(55.62±8.76)岁。PEID组31例,男18例,女13例; 年龄30~68岁,平均(52.31±6.54)岁。术中观察指标包括术中透视次数及手术时间; 手术前后观察指标有术前、出院时、术后1个月、末次随访腰腿痛VAS评分、ODI评分; 最终疗效评定用改良MacNab标准评估末次随访优良率。结果:获得随访时间为12~24个月,两组分别为(15.82±3.34)和(15.52±3.61)个月,两组一般资料差异无统计学意义(P>0.05)。PETD组手术时间50~110 min,平均(85.67±26.33)min; 透视次数16~34次,平均(26.46±10.58)次。PEID组手术时间45~90 min,平均(60.38±15.42)min; 透视次数4~14次,平均(6.58±4.41)次; 手术时间及透视次数组间比较,差异有统计学意义(P<0.05)。各组手术前后评分指标比较,有统计学意义(P<0.05); 同时间段两组评分指标及末次疗效对比差异均无统计学意义(P>0.05)。PETD组出现1例神经根损伤,1例术后1个月复发,行二次PETD手术; PEID组术后1例出现足跖屈肌麻痹,予保守治疗后肌力恢复至4级; 两组病例均无脑脊液漏、节段错误、椎间盘炎等并发症出现。结论:PETD和PEID治疗腰5/骶1椎间盘突出症疗效确切,两者各有其优势,相互补充,术者应依据解剖特点因人而异实施,确保手术疗效。

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备注/Memo

备注/Memo:
基金项目:湖北省自然科学基金(2018CFB487)通信作者 E-mail:spine672@163.com(收稿日期:2019-09-17)
更新日期/Last Update: 2020-05-10