经皮椎间孔镜YESS与TESSYS技术结合治疗多节段腰椎间盘突出症.pdfVIP

·398 · 临床骨科杂志　 Journal of Clinical Orthopaedics　 2015 Aug;18(4) doi:10.3969/ j.issn.1008-0287.2015.04.005 ·临床论著 · 经皮椎间孔镜YESS与TESSYS技术结合治疗多节段腰 椎间盘突出症 何升华,孙志涛,马笃军,王业广,李仕斌 摘要:目的　 探讨经皮椎间孔镜YESS与TESSYS技术结合治疗多节段腰椎间盘突出症的手术技巧及临床疗 效。 方法　 对52例经保守治疗无效的多节段腰椎间盘突出症患者术后采用经皮椎间孔镜YESS与TESSYS 技术结合治疗。 比较术前、术后1周、术后半年的下腰痛JOA评分和Oswestry 功能障碍指数(ODI),进行改良 MacNab疗效评定。 结果　 手术时间72~139(116±23)min,术中出血量3~35(19±12)ml。 术后患者均未出 现感染、神经损伤、椎管内血肿等并发症。 术后1周52例获得随访,术后半年48例获得随访。 术后 1周改良 MacNab疗效评价:优45例,良5例,可1例,差1例,优良率96%;术后1周下腰痛JOA评分、ODI值与术前比 较差异均有统计学意义(P0．01),术后半年下腰痛JOA评分、ODI值以及改良MacNab疗效评定与术后1周 比较差异均无统计学意义(P 0．05)。 结论　 根据多节段腰椎间盘突出症突出类型,采用经皮椎间孔镜 YESS与TESSYS技术结合治疗是一种安全、微创、疗效满意的方法。 关键词:多节段;腰椎间盘突出症;经皮椎间孔镜髓核摘除术 中图分类号:R681.5;R687.3　 文献标识码:A　 文章编号:1008-0287(2015)04-0398-04 The combinationoftheYESSandTESSYSinpercutaneoustransforaminalendoscopicdiscec- tomy to treat multi-segmental lumbar disc herniation　 HE Sheng-hua,SUN Zhi-tao,MA Du- jun,WANG Ye-guang,LI Shi-bin　 (Dept of Orthopaedics,the TCM Hospitalof Shenzhen City,Shenz- hen,Guangdong　 518033,China) Abstract:Objective　 To explore technique skill and clinical effectiveness of the combination of the YESS and TESSYS in percutaneous transforaminal endoscopic discectomy in treating multi-segmental lumbar disc herniation. Methods　 52 patients with multi-segmental lumbar disc herniation after failed conservative treatment were treated with percutaneous transforaminal endoscopic discectomy. The clinical outcome were evaluated by JOA score,Oswe- stry disability index(ODI)and modified Macnab criteria in the cases of pre-operation,one week post-operation and thefollowed-up for half a year. Results　 The operative timewas72~139(116±23)min,the amount of peri-opera- tive bleeding was3~35(19±12)ml. 52 caseswerefollowed upfor oneweek,and48 caseswerefollowed upfor six months after surgery. There were no postoperative complications such as infection,nerve injury,and spinal