经椎间孔入路经皮内窥镜下椎间盘切除术治疗相邻节段退变型腰椎椎间盘突出症被引量：9

Percutaneous transforaminal endoscopic discectomy for treatment of adjacent segment degeneration lumbar disc herniation after transforaminal lumbar interbody fusion

暂未订购

导出

摘要目的探讨经椎间孔入路经皮内窥镜下椎间盘切除术(PETD)治疗经椎间孔腰椎椎间融合术(TLIF)术后相邻节段退变(ASD)型腰椎椎间盘突出症的临床疗效。方法回顾性分析2012年12月—2014年12月同济大学附属第十人民医院脊柱外科行PETD治疗的28例TLIF术后相邻节段腰椎椎间盘突出患者的临床资料,记录手术时间,术中出血量,住院天数,术前、术后3个月、术后12个月及末次随访时腰部、下肢疼痛视觉模拟量表(VAS)评分及Oswestry功能障碍指数(ODI),末次随访时采用Mac Nab标准评价临床疗效。结果所有手术均顺利完成,手术时间为(74.0±8.8)min,手术出血量为(32.6±6.8)m L,住院天数为(2.68±1.06)d,随访时间为(25.1±3.4)个月。术后3个月、术后12个月、末次随访时腰痛和下肢痛VAS评分及ODI与术前相比均有改善,差异均有统计学意义(P<0.05)。根据Mac Nab标准,末次随访时患者临床疗效优良率为89.3%。结论 PETD治疗TLIF术后ASD型腰椎椎间盘突出症能够取得较为满意的疗效。 Objective To investigate the clinical efficacy of percutaneous endoscopic transforaminal discectomy(PETD) for treating adjacent segment degeneration(ASD) lumbar disc herniation after transforaminal lumbar interbody fusion(TLIF). Methods From December 2012 to December 2014,the clinical data of 28 cases of ASD lumbar disc herniation after TLIF treated with PETD were analyzed retrospectively. The operation time,intraoperative blood loss,length of stay,as well as low back and leg pain visual analogue scale(VAS) scores and Oswestry disability index(ODI) at pre-operation,postoperative 3 months,postoperative 12 months and final follow-up were recorded,respectively. Mac Nab criteria was used to assess the patient satisfaction at the final follow-up. Results All patients were operated successfully. The operation time was(74.0±8.8)min,and the intraoperative blood loss was(32.6±6.8)m L. The length of stay was(2.68±1.06)d,and the follow-up period was(25.1±3.4)months. The low back and leg pain VAS scores and ODI at postoperative 3 months,postoperative 12 months and final follow-up were all improved compared with those of the pre-operation;the difference was statistically significant(P < 0.05). According to Mac Nab criteria,the excellent and good rate was 89.3%. Conclusion PETD could achieve satisfactory curative effect for ASD lumbar disc herniation after TLIF.

作者黄盛昌吴信波顾昕

机构地区常州市武进中医医院骨科同济大学附属第十人民医院脊柱外科

出处《脊柱外科杂志》 2017年第3期161-166,共6页 Journal of Spinal Surgery

关键词腰椎椎间盘移位内窥镜检查椎间盘切除术经皮外科手术微创性 Lumbar vertebrae Intervertebral disc displacement Endoscopy Diskectomy,percutaneous Surgical procedures,minimally invasive

分类号 R68 [医药卫生—骨科学]

引文网络
相关文献

参考文献2

1魏振,夏青,江海良,李利昕,邵雪萍.改良经椎间孔椎体间融合术治疗高位腰椎间盘突出症[J].中国骨伤,2010,23(4):308-310. 被引量：10
2庄青山,徐兆万,隋国侠,伦登兴,钟军,张扬,季玉栋.Quadrant通道下“L”型截骨刀经椎间孔截骨椎间融合内固定术治疗高位腰椎间盘突出症[J].中华医学杂志,2014,94(37):2929-2933. 被引量：5

二级参考文献36

1王庆敏,陈鲁峰,曾蔚林,吴志君,郑庆丰,胡冬平,林哲辉.经MAST Quadrant通道下微创腰椎融合术近期疗效观察[J].临床骨科杂志,2011,14(6):605-608. 被引量：15
2谭俊铭,叶晓健,贾连顺,李家顺.腰椎融合术的研究进展[J].中国脊柱脊髓杂志,2006,16(5):397-399. 被引量：21
3刘海鹰,王波,王会民,张健,钱亚龙,金朝晖.经椎间孔椎体融合术治疗高位腰椎间盘突出症[J].中华医学杂志,2006,86(25):1740-1742. 被引量：12
4涂强,徐国洲,钟润泉,王少华.侧后方入路手术治疗高位腰椎间盘突出症[J].中国骨伤,2007,20(4):251-252. 被引量：4
5Kim JS,Lee SH,Moon KH,et al.Surgical results of the oblique paraspinal approach in upper Lumbar disc herniation and thoracolumbar junction.Neurosurgery,2009,65(1):95-99.
6Lee KH,Yue WM,Yeo W,et al.Clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion[J] .Eur Spine J,2012,21:2265-2270.
7Beringer WF,Mobasser JP.Unilateral pedicle screw instrumentation forminimally invasive transforaminal lumbar interbody fusion[J] .Neurosurg Focus,2006,20:E4.
8Agrillo U,Panagiotopoulos K,Corbino L,et al.Lateral lumbar interbody fusion via a unilateral true percutaneous approach associated with minimally invasive pedicle screw fixation for degenerative disc disease and lumbar instability,a technical note[J] .Neurosurg Sci,2010,54:65-69.
9Villavicencio AT,Burneikiene S,Roeca CM,et al.Minimally invasive versus open transforaminal lumbar interbody fusion[J] .Surg Neurol Int,2010,31:12.
10Schizas C,Tzinieris N,Tsiridis E,et al.Minimally invasive versus open transforaminal lumbar interbody fusion:evaluating initial experience[J] .Int Orthop,2009,33:1683-1688.