摘要
背景:近年来脊柱内镜技术更新换代,如何有效选择内镜技术治疗腰椎间盘突出症(LDH)是目前研究的主要方向。目的:比较Tessys Isee与Endo-Surgi Plus两种可视化关节突成形技术治疗LDH的早期临床疗效。方法:回顾性分析2020年3~6月采用脊柱内镜微创治疗的L4/5节段LDH患者67例。所有患者均采用局部麻醉。其中36例患者采用Tessys Isee技术行关节突成形(Tessys Isee组),31例患者使用Endo-Surgi Plus技术行关节突成形(Endo-Surgi Plus组)。记录并比较两组患者术中透视次数、关节突成形次数、手术时间及手术前后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科协会评估治疗评分(JOA)、SF-36评分,术后6个月依据改良Mac Nab标准评估早期疗效。结果:两组患者手术时间、术中透视次数差异均无统计学意义(P均>0.05);Endo-Surgi Plus组患者关节突成形次数少于Tessys Isee组患者,且差异有统计学意义(P<0.001)。两组患者术后1周、3个月、6个月疼痛VAS评分、ODI、JOA评分均较术前改善,且差异均有统计学意义(P均<0.001);两组患者术后3个月、6个月SF-36评分均较术前改善,且差异均有统计学意义(P均<0.001)。术前及术后1周、3个月、6个月两组患者疼痛VAS评分、ODI、JOA评分及SF-36评分差异均无统计学意义(P均>0.05)。术后6个月两组患者患者治疗优良率差异无统计学意义(P>0.05)。结论:Tessys Isee与Endo-Surgi Plus两种可视化关节突成形技术治疗LDH均可获得满意的早期临床效果,均为安全、有效的微创手术方式;Endo-Surgi Plus成形效率更高。
Background:Spinal endoscopic technology has been constantly upgrading,and how to effectively select endoscopic technique for the treatment of lumbar disc herniation(LDH)is the main research direction at present.Objective:To compare early clinical efficacy between two visualizing arthroplasty systems,Tessys Isee and Endo-Surgi Plus,for LDH.Methods:A retrospective study was performed in 67 patients with L4/5 segment LDH treated with spinal endoscopy.All the operations were taken under local anesthesia.Tessys Isee was used in 36 patients and Endo-Surgi Plus in 31 patients.The frequency of intraoperative X-ray,the frequency of arthroplasty,the time of operation,visual analogue scale(VAS),Oswestry disability index(ODI),Japanese Orthopaedic Association(JOA)score,the MOS item short from health survey(SF-36)were compared between two techniques.Early efficacy(6 months after surgery)was evaluated by improved Mac Nab standard.Results:There were no significant differences in the operation time or the frequency of intraoperative fluoroscopy between two groups(P>0.05).The number of intraoperative shaping was significantly less in Endo-Surgi Plus group than that in Tessys Isee group(P<0.001).Compared with preoperative ones,the VAS,ODI and JOA scores at 1 week,3 months and 6 months after surgery were significantly improved in both groups(P<0.001),as well as the SF-36 score at 3 months and 6 months after surgery(P<0.001).But there were no significant differences in VAS,ODI,JOA or SF-36 score between the two groups at any time point(P>0.05).Neither was the excellent and good rate evaluated at 6 moths after surgery(P>0.05).Conclusions:Both Tessys Isee and Endo-Surgi Plus can achieve satisfactory early clinical effects for the treatment of LDH.They are safe and effective minimally invasive surgical methods,while Endo-Surgi Plus has higher efficiency in the arthroplasty.
作者
丛志超
许德荣
周传利
马学晓
丛海波
CONG Zhichao;XU Derong;ZHOU Chuanli;MA Xuexiao;CONG Haibo(Department of Orthopaedics,The Affiliated Hospital of Qingdao University,Qingdao 266000,Shandong;Department of Orthopaedics,Weihai Central Hospital,Weihai 264200,Shandong,China)
出处
《中华骨与关节外科杂志》
2021年第7期592-599,610,共9页
Chinese Journal of Bone and Joint Surgery
基金
泰山学者工程专项经费资助项目(ts201511110)
