|
|
|
| Comparative Study of Percutaneous Transforaminal Nucleotomy and Small Incision Interlaminar Nucleus Pulposus Removal for Lumbar Disc Herniation |
| CHEN Kang, LI Keqian, YI Jianhua, et al |
| Suizhou Hospital Affiliated to Hubei Medical College / Suizhou Central Hospital, Hubei Suizhou 441300, China |
|
|
|
|
Abstract Objective: To evaluate the efficacy and safety of percutaneous transforaminal nucleotomy and small incision interlaminar nucleus pulposus in the treatment of lumbar disc herniation. Methods: 70 patients with lumbar disc herniation from December 2016 to July 2018 were enrolled in our hospital. According to the surgical procedure, they were divided into the open window group (n=35) and the endoscopy group (n=35). The fenestration group was treated with small incision interlaminar nucleus pulposus removal, and the endoscopic group was treated with percutaneous transforaminal nucleus pulpectomy. Perioperative conditions (surgery duration, length of incision, intraoperative blood loss, bed rest time, hospital stay), preoperative and postoperative 1 d, postoperative 1 month, postoperative 2 months pain scores, preoperative and postoperative oswestry dysfunction index score (ODI) and Japanese orthopaedic association treatment score (JOA), treatment rate, and complication rate were counted. (VAS). Results: The length of incision in the endoscopy group was shorter than that in the fenestration group. The intraoperative blood loss was less than that in the fenestration group. The length of operation, bed time and hospital stay were shorter than those in the fenestration group (P<0.05). There was no significant difference VAS score between the two groups before operation. (P>0.05), the VAS scores of the two groups were lower than those before surgery (P<0.05), but there was no significant difference between the two groups (P>0.05); There was no significant difference between the two groups (P>0.05). The ODI scores of the two groups were lower than those before operation, and the JOA scores were higher than those before surgery (P<0.05). There was no significant difference (P>0.05). There was no significant difference between the excellent rate of endoscopic treatment (94.29%) and the fenestration group (88.57%) (P>0.05). The incidence of endoscopic complication (8.57%) was lower than that in the window group (28.57%) (P<0.05). Conclusion: Percutaneous transforaminal resection of nucleus pulposus and small incision fenestration of nucleus pulposus can effectively relieve pain and improve lumbar function in patients with lumbar disc herniation. However, percutaneous transforaminal resection of nucleus pulposus has more significant advantages in reducing surgical trauma, and can reduce postoperative complications and has safety.
|
|
|
|
|
|
[1] 赵显,宋涛,孙新宏.椎间孔镜技术与椎板间开窗治疗双节段腰椎间盘突出症的疗效观察[J].临床骨科杂志,2015,18(6):662~666.
[2] Sinkemani A,Hong X,Gao Z X,et al.Outcomes of microendoscopic discectomy and percutaneous transforaminal endoscopic discectomy for the treatment of lumbar disc herniation: a comparative retrospective study[J].Asian Spine,2015,9(6):833~840.
[3] 黄勇全,温俭,陈文明,等.经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症疗效分析[J].上海医药,2017,38(6):21~24.
[4] Passacantilli E,Lenzi J,Caporlingua F,et al.Endoscopic interlaminar approach for intracanal L5‐S1 disc herniation: Classification of disc prolapse in relation to learning curve and surgical outcome[J].Asian Endosc Surg,2015,8(4):445~453.
[5] Liu C,Zhou Y.Percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion for recurrent lumbar disc herniation[J].World Neurosurg,2016,98(1):14~20.
[6] 方卫军,李章华,潘峰,等.经皮椎间孔镜与椎板开窗治疗腰椎间盘突出症的疗效分析[J].现代生物医学进展,2016,16(34):6660~6664.
[7] 郭学文.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临床疗效比较[J].中国医疗器械信息,2016,22(10):48~49.
[8] Gotecha S,Ranade D,Patil S V,et al.The role of transforaminal percutaneous endoscopic discectomy in lumbar disc herniations[J].Craniovertebr Junction Spine,2016,7(4):217~223. |
|
|
|
2019, Vol. 25 
