[1]吴从俊 李涛 张同会 席金涛 李莹 谢维 刘鏐 唐谨 李俊杰.可视化环锯辅助下经皮椎间孔镜技术治疗腰椎间盘突出症[J].中国中医骨伤科杂志,2021,29(03):49-54.
　WU Congjun LI Tao ZHANG Tonghui XI Jintao LI Ying XIE Wei LIU Liu TANG Jin LI Junjie.Visual Circular Saw Assisted Percutaneous Transforaminal Endoscopy in Treating of Lumbar Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(03):49-54.
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可视化环锯辅助下经皮椎间孔镜技术治疗腰椎间盘突出症()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年03期
页码:
49-54
栏目:
临床报道
出版日期:
2021-03-15

文章信息/Info

Title:
Visual Circular Saw Assisted Percutaneous Transforaminal Endoscopy in Treating of Lumbar Disc Herniation
文章编号:
1005-0205(2021)03-0049-06
作者:
吴从俊 李涛 张同会 席金涛 李莹 谢维 刘鏐 唐谨 李俊杰
1湖北六七二中西医结合骨科医院脊柱微创科(武汉,430079 )△通信作者 E-mail:767098776@qq.com
Author(s):
WU Congjun LI Tao ZHANG Tonghui XI Jintao LI Ying XIE Wei LIU Liu TANG Jin LI Junjie
1Department of Orthopaedics,Hubei 672 Orthpopaedics Hospital of Integrated Chinese & Western Medicine,Wuhan 430079,China.
关键词:
可视化;  经皮椎间孔镜;  腰椎间盘突出症;  微创
Keywords:
visualisation;  percutaneous transforaminal endoscopic discectomy;  lumbar disc herniation;  minimally invasive
分类号:
R681.5
文献标志码:
B
摘要:
目的:对比运用可视化环锯辅助下经皮椎间孔镜(VPTED)与传统经皮椎间孔镜(PTED)技术治疗腰椎间盘突出症(LDH)的有效性及临床疗效。方法:回顾性分析2017年6月至2018年6月于本科接受椎间孔镜治疗的51例具有完整随访资料的患者,其中VPTED组25例(男13例,女12例),手术节段L2～3 1例,L3～4 1例,L4～5 13例,L5S1 10例; 年龄35～69岁,平均(54.78±8.33)岁。PTED组26例(男14例,女12例),手术节段L2～3 1例,L3～4 3例,L4～5 14例,L5S1 8例; 年龄33～75岁,平均(56.25±6.41)岁。对两组患者分别于手术前后予视觉模拟评分法(VAS)及功能指数评分(ODI)评估手术疗效,末次随访改良MacNab标准评估患者的疗效。结果:所有患者随访12～24个月,两组分别为(15.52±3.61)和(16.34±6.28)个月,两组一般资料差异无统计学意义(P>0.05)。VPTED组手术时间45～90 min,平均(65.85±18.63)min; 透视次数4～10次,平均(6.16±1.32)次。PTED组手术时间50～110 min,平均(84.36±25.73)min; 透视次数10～16次,平均(12.53±2.21)次。两组手术时间及透视次数相比,差异有统计学意义(P<0.05)。两组组内术后与术前VAS和ODI评分相比,差异有统计学意义(P<0.05); 同时间段两组VAS和ODI评分及末次疗效比较差异均无统计学意义(P>0.05)。PTED组出现1例神经根不全损伤,1例术后1个月复发,行二次PTED手术; 两组均无脑脊液漏、椎间盘炎等并发症出现。结论:可视化环锯辅助下经皮椎间孔镜治疗LDH与传统椎间孔镜具有同等良好疗效,但VPTED具有操作更简便、更安全等优点,值得临床推广应用。
Abstract:
To compare the clinical efficacy of visual circular saw-assisted percutaneous transforaminal endoscopic discectomy(VPTED)and traditional percutaneous transforaminal endoscopic discectomy(PTED)to treat lumbar disc herniation(LDH).Methods:51 patients with complete follow-up data were selected for comparative study a retrospective analysis.They were treated by percutaneous transforaminal endoscopic discectomy in our department from June 2017 to June 2018.There were 25 patients in VPTED group,including 13 males and 12 females.The age ranked from 35 to 69 years old,with an average of(54.78 ±8.33)years old.Operation levels ranked L2～3 1 case,L3～4 1 case,L4～5 13 cases and L5S1 10 cases.There were 26 patients in PTED group including 14 males and 12 females.The age ranked from 33 to 75 years old,with an average age of(56.25±6.41)years old.Operation levels ranked L2～3 1 case,L3～4 3 cases,L4～5 14 cases and L5S1 8 cases.Visual analogue scale(VAS)and functional index score(ODI)were used to evaluate the surgical efficacy of the two groups before and after the operation,and improved MacNab standard was used to evaluate the curative effect of the patients at the last follow-up.Results:All patients were followed up for 12 to 24 months,and the average months of the two groups were(15.52±3.61)and(16.34±6.28)months respectively.There was no significant difference in general data between the two groups(P> 0.05).In VPTED group,the operation time was 45 to 90 min with an average of(65.85±18.63)min.The fluoroscopy times were 4 to 10 times with an average of(6.16±1.32)times.In PTED group the operation time was 50 to 110 min with an average of(84.36±25.73)min.The fluoroscopy times were 10 to 16 times with an average of(12.53±2.21)times.There were differences in the operation time and fluoroscopy times between the two groups(P<0.05).There were significant differences in VAS and ODI scores between the two groups after operation and before operation(P< 0.05),and there were no significant differences in VAS,ODI scores and final efficacy between the two groups during the same period(P> 0.05).In PTED group 1 case had nerve root injury.1 case had recurrence one month after operation and underwent secondary PTED operation,and the two groups had no complications such as cerebrospinal fluid leakage and discitis.Conclusion:Percutaneous transforaminal endoscopic discectomy assisted by visual circular saw is as effective as traditional transforaminal endoscopy to treat LDH,but VPTED has the advantages of simpler operation and safer operation,which is worthy of clinical promotion.

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备注/Memo

备注/Memo:
基金项目:湖北省自然科学基金(2018CFB487)湖北陈孝平科技发展基金会临床研究基金资助项目(CXPJJH12000005-07-10)
更新日期/Last Update: 2021-03-15