Abstract：Objective: To investigate the effect of percutaneous transforaminal endoscopic discectomy (PTED) on surgical efficacy, Oswestry dysfunction index (ODI), serum substance P (SP), prostaglandin E2 (PGE2), neuropeptide Y (NPY) and postoperative adverse events in elderly patients with free lumbar intervertebral disc herniation (M-LDH). Methods: The clinical data of 117 elderly M-LDH patients in our hospital from August 2018 to August 2020 were collected for retrospective analysis. According to the surgical plan, they were divided into a control group (n=58) and an observation group (n=59). The control group underwent mobile microendoscopic discectomy (MMED), and the observation group underwent PTED. The surgical efficacy, perioperative conditions, and postoperative adverse events of the two groups were observed, and the ODI index and pain degree (VAS score), serum SP, PGE2, NPY levels, and inflammatory stress index levels [tumor necrosis factor-α (TNF-α), matrix metalloproteinase-3 (MMP-3), malondialdehyde (MDA)] before and after the operation were compared. Results: The intraoperative blood loss of the observation group was less than that of the control group, and the operation time and the number of fluoroscopy were longer than those of the control group (P<0.05). Compared with the control group, the serum SP, PGE2 and NPY levels were lower in the observation group one month after the operation (P<0.05). Serum levels of TNF-α, MMP-3 and MDA in the observation group were lower than those in the control group on the 3rd day after operation (P<0.05). The VAS and ODI index scores of the observation group were lower than those of the control group at 1 month after operation (P<0.05). There was no significant difference in the incidence of adverse events and the excellent and good rate of surgery at 3 months after operation (P>0.05). Conclusion: PTED is a safe and effective measure for the treatment of elderly patients with M-LDH. It can further relieve inflammatory stress, reduce postoperative lumbar pain, and improve postoperative lumbar spine function. It is worthy of promotion.
王海斌, 王颖. 经皮椎间孔镜技术对老年游离型LDH患者ODI指数疼痛介质的影响[J]. 河北医学, 2021, 27(11): 1849-1856.
WANG Haibin, WANG Ying. The Effect of Percutaneous Transforaminal Endoscopic Technique on ODI Index and Pain Mediators in Elderly Patients with Free LDH. HeBei Med, 2021, 27(11): 1849-1856.
[1] Benzakour T,Igoumenou V,Mavrogenis AF,et al.Current concepts for lumbar disc herniation[J].Int Orthop,2019,43(4):841~851. [2] 李涛,张同会,谢维,等.可视化环锯辅助下椎间孔镜技术治疗脱出游离型腰椎间盘突出症[J].中国临床神经外科杂志,2020,25(9):597~599. [3] Koc M,Bayar B,Bayar K.A Comparison of back pain functional scale with roland morris disability questionnaire,oswestry disability index,and short form 36-health survey[J].Spine (Phila Pa 1976),2018,43(12):877~882. [4] Xu B,Xu H,Ma X,et al.Bilateral decompression and intervertebral fusion via unilateral fenestration for complex lumbar spinal stenosis with a mobile microendoscopic technique[J].Medicine (Baltimore),2018,97(4):e9715. [5] Pan M,Li Q,Li S,et al.Percutaneous endoscopic lumbar discectomy:indications and complications[J].Pain Physician,2020,23(1):49~56. [6] Chen Z,Zhang L,Dong J,et al.Percutaneous transforaminal endoscopic discectomy versus microendoscopic discectomy for lumbar disc herniation:two-year results of a randomized controlled trial[J].Spine (Phila Pa 1976),2020,45(8):493~503. [7] 黎志权.椎间孔镜手术对腰椎间盘突出症患者术后疼痛介质、炎性因子的影响[J].中国医学创新,2019,16(16):127~130. [8] Chang F,Zhang T,Gao G,et al.Therapeutic effect of percutaneous endoscopic lumbar discectomy on lumbar disc herniation and its effect on oxidative stress in patients with lumbar disc herniation[J].Exp Ther Med,2018,15(1):295~299. [9] 史占广.经皮椎间孔镜与椎板开窗髓核摘除术治疗腰椎间盘突出症的效果观察[J].航空航天医学杂志,2019,30(11):1340~1341. [10] 张琪,许海委,范桐顺,等.循经取穴推拿手法结合圆利针法对腰椎间盘突出症患者血清指标、疼痛情况及生活质量的影响[J].中华中医药杂志,2019,34(3):1266~1270.
2021, Vol. 27 
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