Effect of Discectomy via Iliac Crest Approach and Interlaminar Approach on Pain Function and Long-term Recurrence in Patients with L5S1 Disc Herniation
ZHU Bin, et al
Ethnic Hospital of Enshi Tujia and Miao Autonomous Prefecture, Hubei Enshi 445099, China
Abstract：Objective: To investigate the effects of discectomy via iliac crest approach and interlaminar approach on pain, function and long-term recurrence of L5~S1 disc herniation. Methods: From January 2014 to August 2016, 82 patients with lumbar disc herniation who were treated in our hospital were randomly divided into observation group (39 cases) and control group (43 cases). They were treated discectomy via iliac crest approach and intervertebral approach, respectively, both groups were followed up for 24 months. The operation conditions, pain before and after operation (VAS), motor function (ODI score), complications and long-term recurrence after surgery between the two groups were compared. Results: There was no significant difference in the time of postoperative ambulation and average hospitalization between the two groups (P=0.838, 0.169). The operation time, fluoroscopy times and intraoperative bleeding volume in the observation group were significantly higher than those in the control group (P=0.000, 0.000, 0.039). The VAS scores in the lumbar and leg and ODI scores of the two groups were significantly lower than those before operation (P<0.05), The VAS score of the observation group at 3 and 24 months after operation was lower than that of the control group (Pwaist=0.008, 0.002, Pleg = 0.006, 0.001). There was no significant difference in the ODI score between the two groups (P = 0.553, 0.202). There was no significant difference in the incidence of postoperative complications between the two groups (12.82% vs. 18.60%, P=0.474). The recurrence situation was not statistically significant between the two groups(HR=0.531,95%CI[0.107, 2.634], P=0.457). Conclusion: Discectomy via iliac crest approach can significantly relieve pain, restore the activity of patients, and the safety is guaranteed. However, the operation time and fluoroscopy times need to be further optimized.
朱滨, 张岱阳, 张前燕, 华贤章. 经髂嵴入路与经椎板间隙入路椎间盘摘除术治疗L5~S1椎间盘突出症对患者疼痛功能和远期复发的影响[J]. 河北医学, 2019, 25(7): 1221-1225.
ZHU Bin, et al. Effect of Discectomy via Iliac Crest Approach and Interlaminar Approach on Pain Function and Long-term Recurrence in Patients with L5S1 Disc Herniation. HeBei Med, 2019, 25(7): 1221-1225.
[1] 党礌,陈仲强,刘晓光,等.青少年下腰椎间盘突出症的病因分析-腰椎过度承载及腰骶部骨与关节形态变异在发病中的意义[J].中国脊柱脊髓杂志,2015,25(11):991~996. [2] Yu-Tong GU, De-Rong L, Cui Z, et al. The technique and efficacy of percutaneous transforaminal endoscopic surgery for surgical treatment of L5/S1 disc herniation[J]. Chinese Journal of Clinical Medicine, 2017,21(5):231~234. [3] 杨湘江,张洪,曾月东,等.椎板间入路椎间孔镜下摘除L5/S1椎间盘突出髓核技术改进探讨[J].中国内镜杂志,2015,21(3):326~329. [4] 田曦亮,杨群,王博,等.经皮内窥镜下腰椎椎间盘切除术手术入路分析[J].脊柱外科杂志,2015,13(6):342~346. [5] Tang YZ, Wang GQ, Hong-Yi LI. The choice of approach for minimally invasive percutaneous treatment of L_5-S_1 disc herniation[J]. Journal of Cervicodynia & Lumbodynia, 2016,5(14):143~146. [6] 顾宇彤,吕德荣,崔展,等.PTES椎间孔镜技术治疗腰5/骶1椎间盘突出症的技巧及疗效[J].中国临床医学,2017,24(4):497~503. [7] Tezuka F, Sakai T, Abe M, et al. Anatomical considerations of the iliac crest on percutaneous endoscopic discectomy using a transforaminal approach[J]. Spine Journal Official Journal of the North American Spine Society, 2017,17(12):1875~1876. [8] Gu Y, Cui Z, Shao H, et al. Percutaneous transforaminal endoscopic surgery (PTES) for symptomatic lumbar disc herniation: a surgical technique, outcome, and complications in 209 consecutive cases[J]. Journal of Orthopaedic Surgery & Research, 2017,12(1):25.
2019, Vol. 25 
冀公网安备13080202000677号