CAJ | 학술논문

目的评价椎板间隙入路下经皮内镜腰椎间盘摘除术(PELD)治疗中央型腰椎间盘突出症的安全性和疗效.方法 2012年1月至2014年1月,徐州市中心医院、江苏省中西结合医院、苏州大学第一附属医院骨脊柱外科共计27例放射学表现为中央型腰椎间盘突出的腰腿痛患者,通过椎板间隙入路行经皮内镜下椎间盘摘除术,术后3、6、12个月进行详细的随访问卷调查,包括视觉疼痛模拟评分(VAS),Oswestry功能障碍指数(ODI)等.结果所有患者均成功完成微创手术,平均手术时间为41(26～83) min,平均住院日为5(2～7)d,术后每个随访时间点的平均VAS评分及ODI指数较术前明显下降,25例患者下肢疼痛不再发作,但仍有7.4％的患者腰椎间盘突出再次复发,其中1例患者经再次手术(显微镜下椎间盘摘除术),1例患者经保守治疗后疼痛症状明显缓解.结论椎板间隙入路下经皮内镜治疗中央型腰椎间盘突出症在降低再次突出、并发症、手术创伤、医疗费用等方面具备明显的优势.
목적 평개추판간극입로하경피내경요추간반적제술(PELD)치료중앙형요추간반돌출증적안전성화료효.방법 2012년1월지2014년1월,서주시중심의원、강소성중서결합의원、소주대학제일부속의원골척주외과공계27례방사학표현위중앙형요추간반돌출적요퇴통환자,통과추판간극입로행경피내경하추간반적제술,술후3、6、12개월진행상세적수방문권조사,포괄시각동통모의평분(VAS),Oswestry공능장애지수(ODI)등.결과 소유환자균성공완성미창수술,평균수술시간위41(26～83) min,평균주원일위5(2～7)d,술후매개수방시간점적평균VAS평분급ODI지수교술전명현하강,25례환자하지동통불재발작,단잉유7.4％적환자요추간반돌출재차복발,기중1례환자경재차수술(현미경하추간반적제술),1례환자경보수치료후동통증상명현완해.결론 추판간극입로하경피내경치료중앙형요추간반돌출증재강저재차돌출、병발증、수술창상、의료비용등방면구비명현적우세.
Objective To evaluate the safety and efficacy of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of central lumbar disc extrusion via an interlaminar approach.Methods Between January 2012 and January 2014,27 low-back pain patients with radicular central lumbar disc herniations underwent percutaneous endoscopic discectomy through an interlaminar approach.The clinical follow-ups were performed at 3 months,6 months and 1 year with an extensive postoperative questionnaire,including pain visual analog scale (VAS) and Oswestry disability index (ODI).Results Mini-invasive operation was completed successfully in all patients.The mean operative duration was 41 (26-83) min and the average postoperative hospitalization time 5 (2-7) days.The postoperative median VAS and ODI scores significant decreased at all timepoints.Twenty-five patients had no longer leg pain.But the recurrence rate of disc herniation stood at 7.4 ％.One patient undergo reoperation (microscopic discectomy) and another showed a significant relief in pain symptoms after conservative treatment.Conclusion Endoscopic discectomy via an interlaminar approach for central lumbar disc extrusion offers significant advantages of faciliating rehabilitation,reducing complications,minimizing trauma and lowering expenditure.