摘要
目的探讨运用经皮椎间孔镜下髓核摘除术(percutaneous transforaminal endoscopic discectomy,PTED)治疗青年钙化型腰椎间盘突出症(calcified lumbar disc herniation,CLDH)的临床疗效。方法自2015年12月~2017年3月,本院采用PTED治疗20~35岁的青年CLDH患者20例,男15例、女5例。统计手术时间、切口长度、术中出血量、住院时间、术后并发症及术后复查CT中钙化物的去除情况等情况。分别于术前及术后1 d、3个月和2年时,行腰痛、腿痛VAS评分及ODI指数评价;术后3个月时采用改良MacNab标准进行疗效评级。结果20例患者平均手术时间(76.9±37.96)min,切口长度(8.05±0.92)mm,术中出血量(31.75±5.76)mL,住院时间(4.55±0.86)d;术后均未出现切口感染、神经损伤及脑脊液漏等并发症,复查CT钙化物均被大部分或完全去除。术后3个月复查,腰痛、下肢痛VAS评分和ODI指数均较术前有显著下降,差异有显著统计学意义(P<0.01)。术后3个月时,优良率达95%;术后2年随访各指标与术后3个月相比,差异无统计学意义(P>0.05)。结论PTED治疗青年CLDH,具有良好的中期临床疗效,并发症少,值得临床推广应用。
Objective To investigate the clinical efficacy of percutaneous transforaminal endoscopic discectomy(PTED)in the treatment of calcified lumbar disc herniation(CLDH)in adults.Methods From December 2015 to March 2017,20 patients aged 20-35 years old with CLDH were treated with PTED in our hospital,including 15 males and 5 females.The operation time,length of incision,intraoperative blood loss,time of hospitalization,postoperative complications,and postoperative reexamination of calcification in CT were statistically analyzed.Low back pain,VAS score of leg pain and Oswestry disability index(ODI)score were measured before operation and postoperative 1 day,3 months and 2 years.The modified MacNab was evaluated at 3 months after operation.Results The average operation time was(76.9±37.96)min,the length of surgical incision was(8.05±0.92)mm,the intraoperative blood loss was(31.75±5.76)mL,and the average hospitalization time was(4.55±0.86)d.No complications such as incision infection,nerve injury and cerebrospinal fluid leakage were observed after surgery.The calcification was mostly or completely removed according to the review CT.Three months after operation,VAS score and ODI index of low back pain and lower limb pain were significantly lower than before operation(P<0.01).The excellent and good rate was 95%at 3 months after operation,and there was no significant difference between 2-year follow-up and 3-month follow-up(P>0.05).Conclusion PTED in the treatment of CLDH in adults has favourable mid-term clinical efficacy and few complications,which is worthy of being clinically promoted and applied.
作者
蔡鑫
俞鹏飞
李宇卫
杨柳
冯秋香
戴宇祥
李红卫
CAI Xin;YU Peng-fei;LI Yu-wei;YANG Liu;FENG Qiu-xiang;Dai Yu-xiang;LI Hong-wei(Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou,Jiangsu 215009,China)
出处
《颈腰痛杂志》
2021年第2期203-206,共4页
The Journal of Cervicodynia and Lumbodynia
基金
江苏省青年医学重点人才课题项目(编号:QNRC2016253)。
关键词
钙化
腰椎间盘突出症
经皮椎间孔镜
lumbar disc herniation
percutaneous transforaminal endoscopic discectomy
