[1]陈浩雄,黄学成,徐启良,等.两种不同入路脊柱内镜治疗腰4/5腋下型椎间盘突出症的临床研究[J].中国中医骨伤科杂志,2023,31(07):39-47.[doi:10.20085/j.cnki.issn1005-0205.230708 ]
　CHEN Haoxiong,HUANG Xuecheng,XU Qiliang,et al.The Efficacy and Safety of Two Different Approaches of Spinal Endoscopy on the Treatment of L4/5 Subaxillary Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(07):39-47.[doi:10.20085/j.cnki.issn1005-0205.230708 ]
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两种不同入路脊柱内镜治疗腰4/5腋下型椎间盘突出症的临床研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年07期
页码:
39-47
栏目:
临床研究
出版日期:
2023-07-15

文章信息/Info

Title:
The Efficacy and Safety of Two Different Approaches of Spinal Endoscopy on the Treatment of L4/5 Subaxillary Disc Herniation
文章编号:
1005-0205(2023)07-0039-09
作者:
陈浩雄1; 黄学成1; 徐启良1; 李燕娇1
1广州中医药大学深圳医院(福田)(广东 深圳,518034)
Author(s):
CHEN Haoxiong1; HUANG Xuecheng1; XU Qiliang1; LI Yanjiao1
1Shenzhen Hospital of Guangzhou University of Chinese Medicine(Futian),Shenzhen 518034,Guangdong China.
关键词:
腰椎间盘突出症;  椎间孔入路;  椎板间入路;  影像学观察指标;  疗效与安全性
Keywords:
lumbar disc herniation;  intervertebral foramen approach;  interlaminar approach;  imaging observation index;  efficacy and safety
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.230708
文献标志码:
A
摘要:
目的:研究两种不同入路脊柱内镜治疗腰4/5椎间盘腋下型突出的临床疗效及安全性。方法:选择64例符合纳入标准的腰4/5腋下型椎间盘突出症患者,通过随机数字表法分为对照组和治疗组,对照组为经椎间孔入路(PETD组),治疗组为经椎板间隙入路(PEID组); 对两组术前术后下肢疼痛视觉模拟量表(VAS)评分、腰椎功能障碍指数(ODI)评分、Macnab's临床疗效、黄韧带及骨质去除量、Cobb角改变、椎间隙高度指数、椎体后缘滑移程度、手术并发症进行比较。结果:随访1年,经椎间孔入路组患者32例,优良率为81.2%; 经椎板间隙入路组患者32例,优良率为93.7%,差异无统计学意义(P>0.05),但优异率差异有统计学意义(P<0.05)。平均手术时间经椎板间隙入路组少于经椎间孔入路组,差异有统计学意义(P<0.05),两组术后VAS评分及ODI评分均较术前显著改善,差异有统计学意义(P<0.05),两组间腿痛术后VAS评分及ODI评分差异有统计学意义(P<0.05),两组黄韧带及骨质去除量、Cobb角改变、椎间隙高度指数、椎体后缘滑移程度与术前比较差异有统计学意义(P<0.05)。两组手术相关并发症差异无统计学意义(P>0.05)。结论:两种入路脊柱内镜均可用于治疗L4/5腋下型椎间盘突出,经椎板间隙入路组优异率较经椎间孔入路组高; 对比两种入路术前术后影像指标,均不影响脊柱稳定性,安全有效。
Abstract:
Objective:To study the clinical efficacy and safety of two different approaches of spinal endoscopy on the treatment of subaxillary protrusion of lumbar 4/5 intervertebral disc.Methods:64 patients with lumbar 4/5 subaxillary disc herniation who met the inclusion criteria were randomly divided into control group and treatment group,the control group was via intervertebral foramen approach(PETD group),and the treatment group was via intervertebral space approach(PEID group).The visual analogue scale(VAS)score of lower limb pain before and after surgery,lumbar Oswestry disability index(ODI)score,Macnab's clinical efficacy,the amount of ligamentum flavum and bone removal,the change of Cobb angle,the height index of intervertebral space,the degree of posterior edge slip of vertebral body,and the complications of surgery were compared between the two groups.Results:After following up for 1 year,there were 32 patients in the PETD group,with an excellent and good rate of 81.2%,and 32 patients in the PEID group,with an excellent and good rate of 93.7%.There was no statistical difference(P>0.05),but the excellent and good rate had a statistical difference(P<0.05).The average operation time of PEID group was shorter than that of PETD group(P<0.05).The VAS score and ODI score of the two groups were significantly improved after operation(P<0.05).There was statistical difference between the two groups in VAS score and ODI score after leg pain surgery(P<0.05).There was statistical difference between the two groups in the amount of removal of ligamentum flavum and bone,Cobb angle change,intervertebral space height index,and the degree of posterior edge slip of vertebral body.There was no statistical difference between the two groups in surgical complications(P>0.05).Conclusion:Both approaches of spinal endoscopy can be used to treat L4/5 subaxillary disc herniation.The excellent rate of PEID group is higher than that of PETD group; Compared with the preoperative and postoperative imaging indexes of the two approaches,neither of them affects the stability of the spine and is safe and effective.However,the residual rate of symptoms in the posterior approach is lower,and the posterior approach is more recommended.

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备注/Memo

备注/Memo:
基金项目:深圳市福田区科技局公益性科研资助项目(FTWS2021048)
更新日期/Last Update: 2023-07-10