CAJ | 학술논문

背景：腰椎间盘突出症是椎间盘发生退行性变化后，生物化学变化引起腰部疼痛、下肢放射性疼痛的临床综合征。临床常采用经皮椎间孔镜(TESSYS)与椎间盘镜系统治疗，但其疗效具有差异性。 　　目的：比较经皮椎间孔镜与椎间盘镜系统治疗腰椎间盘突出症的临床疗效。 　　方法：回顾性分析134例腰椎间盘突出症患者的治疗及随访资料，根据治疗方法分为经皮椎间孔镜组(76例)和椎间盘镜系统组58例，比较两组患者的术中情况、修复后不同时间的疼痛、腰椎功能变化情况。 　　结果与结论：①腰椎间盘突出症修复前两组患者的目测类比评分、Oswestry功能障碍指数评分比较差异不显著(P>0.05)；两组患者修复后第1，3，6个月及末次随访两项评分均显著的降低(P<0.05)；修复后各时间点经皮椎间孔镜组两项评分均显著的低于椎间盘镜系统组(P<0.05)。②修复前两组患者的日本矫形外科学会评分比较差异不显著(P>0.05)；修复后第1，3，6个月及末次随访经皮椎间孔镜组患者的日本矫形外科学会评分显著高于椎间盘镜系统组(P<0.05)。③末次随访经皮椎间孔镜组的优良率显著高于椎间盘镜系统组(P<0.05)。④经皮椎间孔镜组患者的手术时间、切口长度显著的短于椎间盘镜系统组，两组术中出血量比较差异不显著(P>0.05)。结果表明，经皮椎间孔镜治疗腰椎间盘突出症具有创伤小，修复后患者疼痛轻微，功能恢复良好的优点。
배경：요추간반돌출증시추간반발생퇴행성변화후，생물화학변화인기요부동통、하지방사성동통적림상종합정。림상상채용경피추간공경(TESSYS)여추간반경계통치료，단기료효구유차이성。 　　목적：비교경피추간공경여추간반경계통치료요추간반돌출증적림상료효。 　　방법：회고성분석134례요추간반돌출증환자적치료급수방자료，근거치료방법분위경피추간공경조(76례)화추간반경계통조58례，비교량조환자적술중정황、수복후불동시간적동통、요추공능변화정황。 　　결과여결론：①요추간반돌출증수복전량조환자적목측류비평분、Oswestry공능장애지수평분비교차이불현저(P>0.05)；량조환자수복후제1，3，6개월급말차수방량항평분균현저적강저(P<0.05)；수복후각시간점경피추간공경조량항평분균현저적저우추간반경계통조(P<0.05)。②수복전량조환자적일본교형외과학회평분비교차이불현저(P>0.05)；수복후제1，3，6개월급말차수방경피추간공경조환자적일본교형외과학회평분현저고우추간반경계통조(P<0.05)。③말차수방경피추간공경조적우량솔현저고우추간반경계통조(P<0.05)。④경피추간공경조환자적수술시간、절구장도현저적단우추간반경계통조，량조술중출혈량비교차이불현저(P>0.05)。결과표명，경피추간공경치료요추간반돌출증구유창상소，수복후환자동통경미，공능회복량호적우점。
BACKGROUND:Lumbar disc herniation is a clinical syndrome of lumbar pain and radiated pain of the lower limb induced by biochemical changes after intervertebral disc degeneration. Transforaminal endoscopic spine system (TESSYS) and Yeung endoscopic spine system (YESS) are commonly used in the clinic, but their effects are different. OBJECTIVE:To compare the curative effect of TESSYS and YESS in treatment of lumbar disc herniation. METHODS:Fol ow-up data of 134 cases of lumbar disc herniation were retrospectively analyzed. They were assigned to TESSYS group (n=76) and YESS group (n=58). Intraoperative condition, pain at various time points after repair, and lumbar function changes were compared between the two groups. RESULTS AND CONCLUSION:(1) No significant difference in Visual Analogue Scale and Oswestry Disability Index scores was detected between the two groups before repair (P>0.05). At 1, 3, and 6 months after repair and during final fol ow-up, above scores were significantly decreased in both groups (P<0.05). Above scores were significantly lower in the TESSYS group than in the YESS group at various time points after repair (P<0.05). (2) No significant difference in Japanese Orthopedic Association score was found between the two groups before repair (P>0.05). Japanese Orthopedic Association score was greater in the TESSYS group than in the YESS group at 1, 3 and 6 months fol owing repair and during final fol ow-up (P<0.05). (3) The excel ent and good rate was significantly greater in the TESSYS group than in the YESS group during final fol ow-up (P<0.05). (4) Operation time and incision length were significantly shorter in the TESSYS group than in the YESS group. No significant difference in the amount of bleeding was detectable between the two groups (P>0.05). Results suggest that TESSYS for lumbar disc herniation was characterized by smal trauma, mild pain and good recovery of function.