椎板开窗与椎间孔镜治疗腰椎间盘突出症比较A comparison between intervertebral fenestration and percutaneous transforaminal endoscopic discectomy for treatment of lumbar disc herniation
吴继彬;葛保健;吴东迎;孙玛骥;张星辰;郭开今;袁峰;
摘要(Abstract):
[目的]比较椎板开窗髓核摘除术(fenestration discectomy,FD)和经椎间孔镜髓核摘除术(percutaneous endoscopic lumbar discectomy,PELD)治疗腰椎间盘突出症(lumbar intervertebral disc herniation,LDH)的临床疗效。[方法]2012年6月~2015年2月,将50例初次单节段LDH患者随机分为椎板开窗组(25例)和椎间孔镜组(25例)。两组年龄、性别、病变节段差异无统计学意义(P>0.05),椎板开窗组在全麻下行后路开窗髓核摘除术,椎间孔镜组在局麻下行经皮椎间孔镜髓核摘除术。比较两种术式的切口、手术时间、术中出血量、术后下地及住院时间,比较两组患者术前、术后的视觉疼痛模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)、日本骨科协会评分(Japanese Orthopaedic Association,JOA)。[结果]所有患者均获得随访,平均随访时间17.3个月(12~36个月)。椎板开窗组的手术时间少于椎间孔镜组(P<0.05),椎间孔镜组的切口长度、术中出血量、术后下地时间、住院时间少于椎板开窗组(P<0.05)。两组术后3、12个月ODI、VAS、JOA与术前比较,均明显改善(P<0.05),两组术后12个月的JOA评分改善率差异无统计学意义(P>0.05)。[结论]与椎板开窗组相比,椎间孔镜技术治疗LDH疗效确切,且具有创伤小、恢复快等优点,是治疗LDH更为理想的方法。
关键词(KeyWords): 内窥镜术;椎间盘突出;椎间孔镜;小切口;腰椎
基金项目(Foundation):
作者(Author): 吴继彬;葛保健;吴东迎;孙玛骥;张星辰;郭开今;袁峰;
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