| 杨晋才,海涌,关立,周立金,潘爱星,张扬璞.自制环锯椎间孔一次成形技术在经椎间孔入路经皮内窥镜下椎间盘切除术中的临床价值[J].脊柱外科杂志,2015,13(6):351-355. |
自制环锯椎间孔一次成形技术在经椎间孔入路经皮内窥镜下椎间盘切除术中的临床价值  点此下载全文 (Fulltext) |
| 杨晋才 海涌 关立 周立金 潘爱星 张扬璞 |
| 100020 北京, 首都医科大学附属北京朝阳医院骨科 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2015.06.008 |
| 摘要点击次数: 1264 |
| 全文下载次数: 751 |
| 摘要： |
| 目的 探讨自制椎间孔成形环锯行椎间孔一次成形在经椎间孔入路经皮内窥镜下椎间盘切除术(percutaneous endoscopic transforaminal discectomy,PETD)中的临床应用价值。方法 2014年3月~2015年3月,在PETD中应用自制环锯行椎间孔一次成形治疗77例腰椎椎间盘突出症患者。分析总结自制环锯椎间孔一次成形的技术特点,统计手术时间、术中出血量及术后并发症情况。利用术前、术后1 d、术后3个月及末次随访时患者腰痛和腿痛视觉模拟量表(visual analogue scale, VAS)评分、Oswestry功能障碍指数(Oswestry disability index, ODI)以及MacNab标准评价患者临床疗效。结果 所有患者手术顺利。平均手术时间83 min,术中平均出血量30 mL。无硬膜撕裂、神经损伤、出血、感染等并发症。随访6~24个月,平均9.6个月。腰痛VAS评分术前(4.3±2.1)分,末次随访时为(0.5±1.1)分;腿痛VAS评分术前(7.3±3.0)分,末次随访时为(0.5±0.4)分;末次随访均较术前有显著改善,差异有统计学意义(P<0.05)。ODI术前为(30.1±6.8)%,末次随访时为(5.3±3.1)%,末次随访较术前显著改善,差异有统计学意义(P<0.05)。MacNab标准疗效评价,优74例,良2例,可0例,差1例,优良率为98.7%。结论 PETD治疗腰椎椎间盘突出症采用自制环锯进行椎间孔一次成形,具有操作简单、安全性高、并发症少、临床效果好等优点,值得临床推广应用。 |
| 关键词：腰椎 椎间盘移位 内窥镜检查 椎间盘切除术,经皮 外科手术,微创性 |
| Clinical value of foraminoplasty by self-designed trepan in percutaneous endoscopic transforaminal discectomy for lumbar disc herniation Fulltext |
| YANG Jin-cai HAI Yong GUAN Li ZHOU Li-jin PAN Ai-xing ZHANG Yang-pu |
| Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China |
| Fund Project: |
| Abstract: |
| Objective To evaluate the clinical value of foraminoplasty by the self-designed trepan in the percutaneous endoscopic transforaminal discectomy (PETD) for lumbar disc herniation. Methods From March 2014 to March 2015, a total of 77 lumbar disc herniation cases were treated with PETD applying the self-designed trepan. The technical features of the foraminoplasty was analyzed. The operation time, blood loss during operation and the complications were recorded. Meanwhile, the leg and low back pain visual analogue scale(VAS) scores, Oswestry disability index(ODI) and MacNab criteria were assessed before operation, 1 d and 3 months post-operation and at the final follow-up. Results All the patients went through the surgery successfully. The mean operation time was 83 min. The mean blood loss was 30 mL. No complication was encountered at post-operation. The follow-up time ranged 6-24 months (mean 9.6 months). The low back pain VAS score of pre-operation was 4.3±2.1, and decreased to 0.5±1.1 at the final follow-up; the difference was statistically significant(P<0.05). The leg pain VAS score of pre-operation was 7.3±3.0, and decreased to 0.5±0.4 at the final follow-up; the difference was statistically significant(P<0.05). The ODI of pre-operation was (30.1±6.8)%, and decreased to (5.3±3.1)% at the final follow-up; the difference was statistically significant(P<0.05). Accroding to MacNab criteria, excellent in 74 cases, good in 2 cases and poor in 1 case. The excellent and good rate was 98.7%. Conclusion It is safe and effective to apply the self-designed trepan in PETD for lumbar disc herniation. It has the advantages of simple operation, high safety, less complications and good clinical effect. It worthes clinical promoting. |
| Keywords:Lumbar vertebrae Intervertebral disc displacement Endoscopy Diskectomy, percutaneous Surgical procedures, minimally invasive |
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