[1]张同会 李涛 席金涛 罗程 唐谨 李莹 刘鏐 吴从俊△.经皮内镜治疗L5S1极外侧椎间盘突出症的临床体会[J].中国中医骨伤科杂志,2022,30(05):46-50.
　ZHANG Tonghui LI Tao XI Jintao LUO Cheng TANG Jin LI Ying LIU Liu WU Congjun.Clinical Experience of Percutaneous Endoscopic TransforaminalDiscectomy for L5S1 Far Lateral Lumbar Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(05):46-50.
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经皮内镜治疗L5S1极外侧椎间盘突出症的临床体会()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年05期
页码:
46-50
栏目:
临床报道
出版日期:
2022-05-15

文章信息/Info

Title:
Clinical Experience of Percutaneous Endoscopic TransforaminalDiscectomy for L5S1 Far Lateral Lumbar Disc Herniation
文章编号:
1005-0205(2022)05-0046-05
作者:
张同会1 李涛1 席金涛1 罗程1 唐谨1 李莹1 刘鏐1 吴从俊1△
1湖北六七二中西医结合骨科医院脊柱微创科(武汉,430079)
Author(s):
ZHANG Tonghui1 LI Tao1 XI Jintao1 LUO Cheng1 TANG Jin1 LI Ying1 LIU Liu1 WU Congjun1△
1Hubei 672 Orthopaedic Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430079,China.
关键词:
经皮内镜; 极外侧椎间盘突出症; 椎间隙高度; 腰骶角
Keywords:
percutaneous endoscopic transforaminal discectomy;  far lateral lumbar disc herniation;  intervertebral space height;  lumbosacral angle
分类号:
R681.5
文献标志码:
B
摘要:
目的:探讨经皮内镜治疗L5S1极外侧椎间盘突出症的临床疗效及操作体会。方法:回顾性分析2017年11月至2021年3月间收治的23例L5S1极外侧椎间盘突出症患者临床资料,采取局麻下经皮内镜椎间孔入路术式完成,年龄41～65岁,采用VAS评分、ODI评分及MacNab标准评价手术效果。结果:手术平均时长为57 min,平均出血量约为15 mL; 23例患者随访3～18个月,平均为12.5个月,其中18例患者完整随访1年以上。对手术前后VAS评分、ODI评分进行统计学分析,术后1 d与术前,术后3个月与术后1 d差异有统计学意义(P<0.05),术后12个月与术后3个月差异无统计学意义(P>0.05)。MacNab标准评价临床疗效,优18例,良3例,可1 例,差1例,优良率为91.30%。结论:经皮内镜治疗L5S1极外侧椎间盘突出症具有靶向性强、损伤小、康复快等优势,但术前应全面评估患者椎间隙高度、腰骶角、横突、髂骨、椎间盘突出的位置,避免损伤出孔神经根及影响疗效。
Abstract:
To investigate the clinical efficacy and operation experience of percutaneous endoscopic transforaminal discectomy for L5S1 far lateral lumbar disc herniation.Methods:Clinical data of 23 patients with L5S1 far lateral lumbar disc herniation from November 2017 to March 2021 were retrospectively analyzed.Percutaneous endoscopic transforaminal discectomy approach was performed under local anesthesia,aged 41 to 65 years old,and the surgical results were evaluated by VAS score,ODI score,and MacNab standard.Results:The average duration of surgery was 57 min,and the average blood loss was about 15 mL.23 patients were followed up for 3 to 18 months with an average of 12.5 months,and 18 patients were followed up for more than one year.The VAS score and ODI score before and after surgery were statistically analyzed,and there were significant differences between 1 d after surgery and before surgery,3 months after surgery and 1 d after surgery(P<0.05).There was no significant difference between l2 month and 3 months after operation(P>0.05).MacNab standard evaluation of clinical efficacy was excellent in 18 cases,good in 3 cases,fair in 1 case and poor in 1 case,with an excellent and good rate of 91.30%.Conclusion:Percutaneous endoscopic transforaminal discectomy for L5S1far lateral lumbar disc herniation has the advantages of strong targeting,little injury and quick recovery,etc.But preoperative comprehensive evaluation should be made of patients’ intervertebral space height,lumbosacral angle,transverse process,iliac bone and the position of disc herniation to avoid damage to the perforation root and affect the curative effect.

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备注/Memo

备注/Memo:
基金项目:湖北陈孝平科技发展基金会(CXPJJH12000005-07-10)
△通信作者 E-mail:wucongjun0402@163.com
更新日期/Last Update: 1900-01-01