经皮椎间孔镜手术对不同椎间孔镜下分型腰椎间盘突出症的疗效分析

doi:10.3969/j.issn.1006-6233.2017.05.021

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摘要 目的: 探讨经皮椎间孔镜技术治疗不同椎间孔镜下分型腰椎间盘突出症的手术疗效。方法: 对128例行经皮椎间孔镜手术的腰椎间盘突出症患者进行椎间孔镜镜下分型,共分为4种:压迫型、瘢痕型、钙化型、侧隐窝狭窄型;并采用视觉模拟评分法(visual analog scale,VAS)、Oswestry 功能障碍指数(Oswestry disability index,ODI) 、日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores,JOA)及MacNab 标准评估手术疗效。结果: 经过平均(10.5±3.7)个月的随访,各分型患者腰腿痛VAS评分、ODI评分较术前均明显减低,JOA评分较术前明显升高,MacNab标准评定疗效优良率95.31%,VAS、ODI、JOA差异均有统计学意义(P<0.05)。结论: 经皮椎间孔镜技术对不同椎间孔镜下分型腰椎间盘突出症均有显著疗效,合理利用该分型可以使该手术最大程度地缓解患者的症状,有效提高手术疗效,显著减少术后复发率。

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关键词 ：腰椎间盘突出症, 经皮椎间孔镜, 椎间孔镜下分型

Abstract：Objective: To discuss the curative effect analysis of transforaminal endoscopic discectomy typing method on the lumbar disc herniations. Methods: 128 patients underwent percutaneous transforaminal endoscopic surgery of lumbar disc herniation patients with intervertebral foramen in diagnosing type, was divided into 4 types: compression type, scar, calcification type, lateral recess stenosis type; and the visual analogue score (visual analog, scale, VAS), oswestry disability index (Oswestry disability index ODI, Japan), department of orthopedics (Japanese Orthopaedic Association evaluation scores of Association Scores, JOA) and macNab standard to assess the efficacy of surgery. Results: The average (10.5 + 3.7) months of follow-up, the patients with low back pain VAS score and ODI score were significantly lower than that before operation, JOA was significantly higher than that before operation, MacNab rated excellent rate of 95.31%, VAS, ODI and JOA had significant difference (P<0.05). Conclusion: Percutaneous transforaminal endoscopic surgery for lumbar disc herniation are significantly different efficacy of transforaminal endoscopic, rational use of the classification can make the surgery greatly alleviate symptoms, improve curative effect, reduce the recurrence rate.

Key words： lumbar disc herniations transforaminal endoscopic discectomy Transforaminal endoscopic discectomy typing method

引用本文:

杨波, 鹿洪辉, 杨蓓, 卢晨晓, 常成兵, 陈宾. 经皮椎间孔镜手术对不同椎间孔镜下分型腰椎间盘突出症的疗效分析[J]. 河北医学, 2017, 23(5): 776-779.
YANG Bo, et al. Analysis of the Efficacy of Percutaneous Endoscopic Discectomy for Lumbar Intervertebral Disc Herniation. 河北医学, 2017, 23(5): 776-779.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2017.05.021 或 http://www.hbyxzzs.cn/CN/Y2017/V23/I5/776

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