摘要
目的:分析评估经皮椎间孔镜(percutaneous transforaminal endoscopic discectomy,PTED)与椎间盘镜(microendoscopic discectomy,MED)在治疗腰椎间盘突出症(lumbar disc herniation,LDH)病人中的临床疗效。方法:选取2013年1月至2015年6月在西安市红会医院脊柱外科住院治疗的LDH病人92例,其中经PTED治疗的病人48例,MED治疗的病人44例,统计两组间围手术期参数、术前、术后腰背痛和下肢痛视觉模拟评分(visual analogue scores,VAS),Oswestry功能障碍指数(oswestry disability index,ODI)等评定标准来评估手术效果及术后生活质量。结果:手术时间PTED组明显高于MED组(P<0.05),但术中出血量、平均住院时间组间无差异(P>0.05);术后3 d,PTED组腰背痛VAS评分低于MED组(P<0.05);术后1年Nalai疗效评级、Mac Nab疗效评定标准和SF-36量表分析及差异无统计学意义(P>0.05)。结论:在单节段腰椎间盘突出症病人的治疗中,PTED和MED可取得相似的手术疗效,其远期手术效果有待于进一步大样本长期观察随访。
Objective： To evaluate the safety and the clinical effects of MED and PTED in the treatment of LDH. Methods： A retrospective study was performed in patients with LDH treated with MED（n =44） and transforaminal endoscopic discectomy（PTED; n =48） in our hospital. All patients were followed-up with self-evaluation questionnaires, including oswestry disability index（ODI）, visual analogue scores（VAS） before and after the surgery and,to evaluate the operative effects and postoperative quality of life. Results： The VAS of back pain was significantly lower in patients 3 days, 5 days and 3 months after PTED than in those after MED（P 〈 0.05）.No significant difference was found in VAS and ODI scores of back and leg pain（P 〉 0.05）. According to Mac Nab criteria, 92.0% of the MED group and 94.4% of the PTED group had excellent or good results with no significant difference. Conclusions： There was no significant difference between MED and PTED outcomes. Further large-scale, randomized studies with long-term follow-up are needed.
出处
《中国疼痛医学杂志》
CAS
CSCD
2017年第6期438-442,共5页
Chinese Journal of Pain Medicine
关键词
经皮椎间孔镜
椎间盘镜
微创
腰椎间盘突出症
Percutaneous transforaminal endoscopic discectomy
Microendoscopic discectomy
Minimally invasive surgery
Lumber disc herniation
