| 张黎明,杨晋才,尹鹏,潘爱星,丁一,许春阳.采用改良经椎间孔内窥镜脊柱系统行经皮椎间孔成形术治疗老年腰椎椎间盘突出症[J].脊柱外科杂志,2020,18(5):305-309. |
采用改良经椎间孔内窥镜脊柱系统行经皮椎间孔成形术治疗老年腰椎椎间盘突出症  点此下载全文 (Fulltext) |
| 张黎明1 杨晋才2* 尹鹏2 潘爱星2 丁一2 许春阳2 |
1. 首都医科大学电力教学医院(国家电网公司北京电力医院)
骨二科, 北京 100073;
2. 首都医科大学附属北京朝阳医院骨科, 北京 100020 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2020.05.004 |
| 摘要点击次数: 607 |
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| 摘要： |
| 目的 探讨采用改良经椎间孔内窥镜脊柱系统（TESSYS）行经皮椎间孔成形术治疗老年腰椎椎间盘突出症的临床疗效。方法 回顾性分析2016年4月—2017年12月采用改良TESSYS行经皮椎间孔成形术治疗的60例老年（≥60岁）单节段腰椎椎间盘突出症患者临床资料。记录手术前后腰腿痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI），采用改良MacNab标准评定手术疗效。结果 所有手术顺利完成，手术时间为65~180 min，平均106 min；出血量为15~50 mL，平均35 mL。术中未发生重要血管或神经损伤、硬膜撕裂等严重并发症，术后伤口均愈合良好，未出现伤口感染、脑脊液漏等并发症。4例患者疗效不满意，经非手术治疗无效后转为开放手术治疗。其余56例随访12~32个月，平均18.6个月，术后1 d、3个月及末次随访腰腿痛VAS评分及ODI均较术前改善，差异有统计学意义（P < 0.05）。末次随访时采用改良MacNab标准评定疗效：优38例，良15，可3例，差4例（转开放手术者），优良率为88.3%。结论 采用改良TESSYS行经皮椎间孔成形术治疗老年腰椎椎间盘突出症安全、有效。 |
| 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 老年人 |
| Percutaneous foraminoplasty with modified transforaminal endoscopic spine system for treatment of lumbar disc herniation in elderly Fulltext |
| ZHANG Li-ming1 YANG Jin-cai2* YIN Peng2 PAN Ai-xing2 DING Yi2 XU Chun-yang2 |
1. Second Department of Orthopaedics, Electric Teaching Hospital(State Grid Coporation of China Beijing Electric Power Hospital)
, Capital Medical University, Beijing 100073, China;
2. Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China |
| Fund Project: |
| Abstract: |
| Objective To explore the clinical efficacy of percutaneous foraminoplasty with modified transforaminal endoscopic spine system（TESSYS） for treatment of lumbar disc herniation in the elderly. Methods From April 2016 to December 2017，the clinical data of 60 elderly patients（≥60 years old） with single segment lumbar disc herniation treated by percutaneous foraminoplasty with modified TESSYS were retrospectively analyzed. The low back and leg pain visual analogue scale（VAS） score and Oswestry disability index（ODI） were recorded before and after operation，and the outcome of operation was evaluated by modified MacNab criteria. Results All the operations were successfully completed. The operation time was 65-180 min， mean 106 min；the blood loss was 15-50 mL，mean 35 mL. No major vascular or nerve injury dural tear or other serious complications occurred during the operation. The wounds healed well，no complications such as wound infection and cerebrospinal fluid leakage occurred after operation. Four patients were unsatisfactory after the operation，and the non-surgical treatment was ineffective，converted to open surgery. The remaining 56 patients were followed up for 12-32 months，mean 18.6 months. The low back and leg pain VAS scores and ODI were improved at postoperative 1 d，3 months and the final follow-up，with statistical significances（P < 0.05）. According to modified MacNab criteria at the final follow-up，excellent outcome was achieved in 38 cases，good in 15，fair in 3 and poor in 4（converted to open surgery），the excellent and good rate was 88.3%. Conclusion It is safe and effective to treat lumbar disc herniation in the elderly by percutaneous foraminoplasty with modified TESSYS. |
| Keywords:Lumbar vertebrae Intervertebral disc displacement Endoscopy Diskectomy,percutaneous Surgical procedures,minimally invasive Aged |
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