摘要
目的探讨全内镜下椎板开窗减压(full endoscopic lamina fenestration discectomy,Endo-LOVE)联合内镜下神经根射频脉冲(nerve root pulsed radiofrequency,NR-PRF)治疗腰椎退行性疾病(lum⁃bar degenerative disease,LDD)的临床疗效,聚焦术后残留症状的改善。方法回顾性分析2022年1月至2023年6月在医院诊治的102例LDD患者,其中观察组(Endo-LOVE联合NR-PRF)53例,对照组(单纯Endo-LOVE)49例,平均随访时间为(15.05±1.15)个月。对比两组患者一般资料,并于术前、术后1 d、7 d、1个月、3个月、6个月及末次随访时间点进行观察,比较两组围手术期临床数据及随访结果。结果术前两组间一般情况、临床指标(VAS、M-JOA和ODI评分)均差异无统计学意义,术后两组临床指标较术前均有明显改善(P<0.05)。观察组术后3个月内各临床指标及术后患肢疼痛、麻木等残留症状改善均明显优于对照组(P<0.05),术后6个月、末次随访两组间临床指标及末次随访时Macnab评分均差异无统计学意义(P>0.05)。结论Endo-LOVE治疗LDD具有较高的安全性和可靠性,结合内镜下NR-PRF进一步提高了临床疗效,降低了术后残留症状的发生率,有助于术后快速康复。这种优势互补的联合为LDD提供了一种全新的治疗思路。
Objective To explore the clinical effectiveness of full endoscopic lamina fenestration discec⁃tomy(Endo-LOVE)in combination with nerve root pulsed radiofrequency(NR-PRF)in the treatment of lumbar degenerative disease(LDD),along with the amelioration of postoperative residual symptoms.Methods A retro⁃spective analysis was performed on 102 patients with LDD who were treated in our hospital between January 2022 and June 2023.Among them,53 cases were assigned to the observation group(receiving Endo-LOVE combined with NR-PRF),and 49 cases were included in the control group(undergoing Endo-LOVE alone).The mean follow-up period was 15.05±1.15 months.The general data of the two groups were compared.Observations were carried out at preoperative,1-day,7-day,1-month,3-month,6-month,and final follow-up time points postopera⁃tively.The perioperative data and follow-up outcomes of the two groups were compared.Results Prior to surgery,no significant disparities were detected in the general conditions and clinical observation indicators(VAS,M-JOA,and ODI scores)between the two groups.Postoperatively,both groups exhibited a notable improvement in clinical indicators when compared to the preoperative levels(P<0.05).Within three months after surgery,the observation group showed significantly more pronounced improvement in all clinical indicators than the control group(P<0.05).At six months postoperatively and during the final follow-up,no statistically significant differences in clinical indi⁃cators were found between the two groups.Moreover,at the final follow-up,there was no statistically significant difference in the Macnab scores between the two groups(P>0.05).Conclusion Endoscopic decompression for the treatment of LDD exhibits high safety and reliability.When combined with endoscopic NR-PRF,it enhances the clinical efficacy,reduces the incidence of postoperative residual symptoms,and facilitates rapid postoperative recovery.This complementary combination presents a novel therapeutic strategy for LDD.
作者
热波特·肉孜
张晗硕
杨广南
白杰
蒋强
卢正操
李雯
丁宇
REBOTE Rouzi;ZHANG Hanshuo;YANG Guangnan;BAI Jie;JIANG Qiang;LU Zhengcao;LI Wen;DING Yu(Chinese PLA Medical School,Beijing 100853,Beijing,China;Orthopedics of TCM Senior Department,the Sixth Medical Center of PLA General Hospital,Beijing 100048,Beijing,China;不详)
出处
《实用医学杂志》
北大核心
2025年第12期1800-1807,共8页
The Journal of Practical Medicine
基金
国家自然科学基金项目(编号:82274637)。
关键词
腰椎退行性疾病
内镜减压
神经根射频脉冲
联合治疗
临床疗效
lumbar degenerative disease
endoscopic decompression
nerve root pulsed radiofre⁃quency
combination therapy
clinical efficacy
