CAJ | 학술논문

目的：评价椎间孔镜治疗有典型根性症状的腰椎手术失败综合征（failedbacksurgerysyndrome，FBSS）的临床效果。方法选择2012年11月～2013年6月12例有典型根性症状的FBSS，其中腰椎间盘突出单纯开窗髓核摘除术后复发5例，腰椎管狭窄髓核摘除并神经根管减压术后复发3例，腰椎间盘突出椎间孔镜髓核摘除术后复发4例。均采用椎间孔镜治疗。结果12例术后患肢直腿抬高试验阴性，神经根刺激所致的患肢疼痛症状均明显缓解，患肢疼痛评分依据视觉模拟评分法（visualanaloguescore，VAS），术前8．3±1．9，术后1个月2．6±1．1（t＝16．301，P＝0．000）。结论椎间孔镜是治疗有典型根性症状的FBSS安全和有效的微创手术，合理选择手术适应证和成熟的椎间孔镜手术经验是保证手术成功的关键。
목적：평개추간공경치료유전형근성증상적요추수술실패종합정（failedbacksurgerysyndrome，FBSS）적림상효과。방법선택2012년11월～2013년6월12례유전형근성증상적FBSS，기중요추간반돌출단순개창수핵적제술후복발5례，요추관협착수핵적제병신경근관감압술후복발3례，요추간반돌출추간공경수핵적제술후복발4례。균채용추간공경치료。결과12례술후환지직퇴태고시험음성，신경근자격소치적환지동통증상균명현완해，환지동통평분의거시각모의평분법（visualanaloguescore，VAS），술전8．3±1．9，술후1개월2．6±1．1（t＝16．301，P＝0．000）。결론추간공경시치료유전형근성증상적FBSS안전화유효적미창수술，합리선택수술괄응증화성숙적추간공경수술경험시보증수술성공적관건。
Objective To evaluate clinical results of transforaminal endoscopic spine system in the treatment of failed back surgery syndrome (FBSS) with typical radicular symptoms. Methods Twelve patients with typical radicular symptoms of FBSS were treated by transforaminal endoscopic spine system from November 2012 to June 2013.Among the patients , there were 5 cases of relapse of lumbar disc herniation after simple windowing disectomy , 3 cases of relapse of lumbar spinal stenosis after disectomy and nerve radicular decompression procedure , and 4 cases of relapse of lumbar disc herniation after percutaneous transforaminal endoscopic discectomy . Results In all the 12 patients , limb radicular symptoms were relieved postoperatively , with negative straight leg raising test.Limb pain was measured by means of the Visual Analogue Score (VAS).The mean VAS was significantly decreased from (8.3 ± 1.9) points before the surgery to (2.6 ±1.1) points at one month after the surgery (t =16.301, P=0.000). Conclusions Transforaminal endoscopic spine system is safe and efficacious in the treatment of FBSS with typical radicular symptoms .Proper selection of patients and skilled performance are the key to a successful operation .