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（P〈0．01）,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。
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 the followed-up for half a year. Results The operative time was 72∽139（116 ± 23） min,the amount of peri-opera-tive bleeding was 3∽35（19 ± 12）ml. 52 cases were followed up for one week,and 48 cases were followed up for six months after surgery. There were no postoperative complications such as infection,nerve injury,and spinal canal he-matoma in all the cases; One week post-operation,evaluation of modified MacNab effects were as follows：45 cases were rated as excellent, 5 cases were good,1 case was fair, 1 case was poor, the excellent and good rate was 96%. There was significant difference between one week post-operation group and pre-operation group which were assessed with JOA score and ODI（P〈0. 01）;There was no significant difference between half a year post-operation group and one week post-operation group which were assessed with JOA score,ODI and improved MacNab curative effect evalua-tion （P〉0. 05）. Conclusions According to prominent type of multi-segmental lumbar disc herniation, percutane-ous transforaminal endoscopic discectomy combined with YESS and TESSYS for multi-segmental lumbar disc hernia-tion is a safe,minimally invasive, satisfactory methods of treatment.
出处
《临床骨科杂志》
2015年第4期398-401,共4页
Journal of Clinical Orthopaedics
关键词
多节段
腰椎间盘突出症
经皮椎间孔镜髓核摘除术
multi-level disc
lumbar disc herniation
percutaneous transforaminal endoscopic discectomy
