CAJ | 학술논문

目的：评价经皮椎间孔内窥镜下腰椎间盘切除术治疗腰椎间盘突出症的初期疗效。方法2013年12月至2014年5月采用 TESSYS 技术行经皮椎间孔内窥镜下腰椎间盘切除术，治疗腰椎间盘突出症患者117例。记录患者术前、术后不同时间点的腰腿痛 VAS 评分；记录术前、术后患者的 Oswestry 功能障碍指数（ODI），评价腰椎功能情况；根据 MacNab 疗效评价标准，记录术后3月疗效结果。结果117例手术均顺利完成，术后当日即可佩戴腰围下床活动。患者腰痛、下肢痛 VAS评分由术前的6.98、8.19分下降至术后1 d 3.21、2.83分，术后1月2.06、2.45分，术后3月1.64、1.92分，术后各时间点VAS 评分与术前相比均有显著性差异（P ＜0.01）。 ODI 由术前的75．93％降至术后3月时21.46％。术后3月随访，按照MacNab 评价标准，优者51例（43.59％），良者59例（50.43％），可者7例（5.98％），差者0例，有效率100％，优良率94.02％。结论采用 TESSYS 技术行经皮椎间孔内窥镜下腰椎间盘切除术治疗腰椎间盘突出症效果显著，具有创伤小、卧床时间短、并发症少、术后恢复快等优点。
목적：평개경피추간공내규경하요추간반절제술치료요추간반돌출증적초기료효。방법2013년12월지2014년5월채용 TESSYS 기술행경피추간공내규경하요추간반절제술，치료요추간반돌출증환자117례。기록환자술전、술후불동시간점적요퇴통 VAS 평분；기록술전、술후환자적 Oswestry 공능장애지수（ODI），평개요추공능정황；근거 MacNab 료효평개표준，기록술후3월료효결과。결과117례수술균순리완성，술후당일즉가패대요위하상활동。환자요통、하지통 VAS평분유술전적6.98、8.19분하강지술후1 d 3.21、2.83분，술후1월2.06、2.45분，술후3월1.64、1.92분，술후각시간점VAS 평분여술전상비균유현저성차이（P ＜0.01）。 ODI 유술전적75．93％강지술후3월시21.46％。술후3월수방，안조MacNab 평개표준，우자51례（43.59％），량자59례（50.43％），가자7례（5.98％），차자0례，유효솔100％，우량솔94.02％。결론채용 TESSYS 기술행경피추간공내규경하요추간반절제술치료요추간반돌출증효과현저，구유창상소、와상시간단、병발증소、술후회복쾌등우점。
Objective To evaluate the primary clinical outcome of percutaneous transforaminal endoscopic lumbar discectomy for lumbar disc herniation .Methods 117 patients who were confirmed lubmar disc herniation were treated with percutaneous transforaminal endoscopic lumbar discectomy by TESSYS technique from December 2013 to May 2014 .The preoperative and postoperative visual analogue scale(VAS) for low back pain and sciatica at different time points were compared .The Oswestry disability index(ODI) was evaluated to judge the lumbar function .The MacNab criteria was employed to grade the clinical out‐come at 3rd month after operation .Results 117 cases of operation were all completed successfully .The mean VAS score of low back and sciatica decreased from preoperative 6.98 and 8.19 respectively to postoperative 3.21 and 2.83 at 1‐day follow‐up , 2.06 and 2.45 at 1‐month follow‐up ,1.64 and 1.92 at 3‐month follow‐up(P< 0.01) .ODI improved from preoperative 75.93%to 21.46% at 3‐month follow‐up .According to the Macnab criteria ,there were excellent outcomes in 51 patients (43.59% ) , good outcomes in 59 patients(50.43% ) fair outcomes in 7 patients (5.98% ) and no poor outcome at the last follow‐up .And the excellent‐to‐good rate was 94.02% .Conclusion Percutaneous transforaminal endoscopic lumbar discectomy by TESSYS technique provides an effective way to treat lumbar disc herniation due to its high percentage of patient satisfaction ,which has many advantages such as little trauma ,brief hospitalization ,fewer complications ,faster post‐surgical rehabilitation .