椎间孔镜技术治疗腰椎间盘突出症近期疗效分析.docVIP

椎间孔镜技术治疗腰椎间盘突出症近期疗效分析 　　【摘要】 目的：探讨经皮椎间孔镜技术（percutaneous endoscopic lumbar discectomy，PTED）治疗腰椎间盘突出症患者的近期疗效。方法：回顾性分析本院2014-2015年25例行椎间孔镜治疗的腰椎间盘突出症患者，手术方式均采用PTED技术中的TESSYS技术，术后1周、1个月及12个月采用视觉模拟（Visual Analogue Scale/ Score，VAS）评分法和改良MacNab疗效评定标准评价其手术效果。结果：所有患者均获得1年的随访，均未发生神经损伤等严重并发症，术后1周及术后1个月、12个月的VAS评分分别为（2.35±0.58）分、（1.79±0.48）分及（1.35±0.58）分，均显著低于术前的（8.22±0.63）分，手术前后比较差异有统计学意义（P0.05）。根据改良MacNab疗效评定：优20例，良3例，可1例，差1例。术后复发1例，1例一过性下肢疼痛，经积极治疗均获得满意恢复。结论：椎间孔镜技术治疗腰椎间盘突出症创伤小、恢复快、并发症少，近期疗效可靠，是治疗腰椎间盘突出症的一种安全、有效的方法。 　　【关键词】 腰椎间盘突出症； 椎间孔镜； 微创； 髓核摘除术 　　【Abstract】 Objective：To analysis the recent curative effect of percutaneous endoscopic lumbar discectomy on protrusion of lumbar intervertebral disc.Method：25 cases with lumbar mirror holes for treatment of lumbar disc herniation were retrospectively analyzed from 2014 to 2015，they were given TESSYS technology in PTED surgical methods，the surgery effects of postoperative 1 week， 1 month and 12 months were evaluated by visual analogue scale score method and modified MacNab criteria.Result：All patients were obtained 1 year of follow-up，there were no serious complications such as nerve injury.Postoperative 1 week， 1 month and 12 months the VAS scores were respectively （2.35±0.58）scores，（1.79±0.48）scores and （1.35±0.58） scores were significantly lower than preoperative （8.22±0.63） scores，the differences were statistically significant（P0.05）.According to the improved MacNab efficacy evaluation：excellent in 20 cases，good in 3 cases， fair in 1 cases and poor in 1 cases. Postoperative recurrence in 1 case，1 case of postoperative pain in the lower extremities，after active treatment to obtain satisfactory recovery.Conclusion：The PTED treatment of lumbar intervertebral disc herniation is a safe and effective method，with less trauma，faster recovery， less complication and reliable curative effect. 　　【Key words】 Protrusion of lumbar intervertebral disc； Intervertebral foramen； Minimally invasive； Excision of nucleus pulposus 　　First-autho