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医学临床研究  2023, Vol. 40 Issue (4): 515-518    DOI: 10.3969/j.issn.1671-7171.2023.04.010
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经皮椎间孔镜下TESSYS技术治疗老年腰椎间盘突出的效果及对MRI指标和生活质量的影响
李龙, 郭一帆*
商洛市中心医院脊柱外科,陕西 商洛 726000
Application of TESSYS Technique under Percutaneous Foraminal Endoscopy in the Treatment of Senile Lumbar Disc Herniation and its Effects on MRI Indexes and Life Quality
LI Long, GUO Yi-fan
Department of Spine Surgery,Shangluo Central Hospital,Shangluo Shaanxi 726000
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摘要 【目的】经皮椎间孔镜下椎间孔内镜脊柱系统(transforaminal endoscopic spine system,TESSYS)技术治疗老年腰椎间盘突出的临床效果及对患者磁共振(MRI)指标和生活质量的影响。【方法】选取2018年3月至2021年2月本院收治的98例老年腰椎间盘突出患者,按照治疗方法不同分为对照组和观察组,每组49例。对照组患者采用传统椎板开窗髓核摘除术治疗,观察组患者采用经皮椎间孔镜下TESSYS技术治疗。比较两组患者手术指标(手术时间、切口长度、术中出血量、术后卧床和住院时间)、术后并发症及手术前后血清内皮素(ET)、皮质醇(Cor)、血管紧张素Ⅱ(Ang Ⅱ)和去甲肾上腺素(NE)水平;在术前和术后6个月时采用Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)、世界卫生组织生存质量测定量表(WHOQOL-BREF)评价患者腰椎功能、疼痛程度和生活质量,并通过MRI测量椎管横截面积、椎间孔面积和椎间孔中部矢状径,术后6个月采用改良Mac Nab标准评价临床疗效。【结果】观察组患者手术时间、切口长度、术中出血量、术后卧床和住院时间均显著短于或少于对照组(P<0.05)。术后6个月,两组患者VAS、ODI评分均较术前显著降低(P<0.05),且观察组患者均显著低于对照组,差异有统计学意义(P<0.05)。观察组患者术后6个月WHOQOL-BREF各维度评分显著高于对照组(P<0.05)。两组术前和术后椎管横截面积、椎间孔面积和椎间孔中部矢状径比较,差异均无统计学意义(P>0.05)。观察组Mac Nab标准分级优良率为93.88%,与对照组的91.84%比较,差异无统计学意义(P>0.05)。两组患者术后均无明显并发症。【结论】经皮椎间孔镜下TESSYS技术治疗老年腰椎间盘突出的疗效满意,可显著改善患者MRI指标和生活质量,具有创伤小、术后恢复快等优势,值得临床推广应用。
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李龙
郭一帆
关键词 椎间盘移位/外科学椎间盘切除术,经皮生活质量治疗结果    
Abstract:【Objective】 To evaluate the clinical effect of percutaneous foraminal endoscopic transforaminal endoscopic spine system (TESSYS) in the treatment of senile lumbar intervertebral disc and its effect on MRI indexes and life quality. 【Methods】 A total of 98 elderly patients with lumbar disc herniation treated in our hospital from March 2018 to February 2021 were randomly divided into control group and the observation group,with 49 cases in each group. The patients in the control group were treated with traditional laminectomy,while the patients in the observation group were treated with TESSYS technique under percutaneous foraminal endoscopy. The operation indexes (operation time,incision length,intraoperative bleeding,postoperative bed rest and hospitalization time),postoperative complications,and levels of serum endothelin (ET),cortisol (Cor),angiotensin Ⅱ (Ang Ⅱ) and norepinephrine (NE) levels before and after operation were compared between the two groups. The lumbar function,pain and life quality were evaluated by Oswestry dysfunction index (ODI),VAS and WHOQOL-BREF before and 6 months after operation. The cross-sectional area of spinal canal,the area of intervertebral foramen and the midsagittal diameter of intervertebral foramen were measured by MRI. The clinical efficacy was evaluated by modified Mac Nab standard in 6 months after operation. 【Results】 The operation time,incision length,intraoperative bleeding,postoperative bed rest and hospital stay in the observation group were significantly shorter than or less than those in the control group (P<0.05). Six months after surgery,the VAS and ODI scores in the two groups were significantly lower than those before operation (P<0.05). The VAS and ODI scores of the observation group were significantly lower than those of the control group (P<0.05).The scores of WHOQOL-BREF in the observation group at 6 months after operation were significantly higher than that in the control group (P<0.05).There were no significant differences in the cross-sectional area of spinal canal,the area of intervertebral foramen and the sagittal diameter of the middle part of intervertebral foramen between the two groups before and after operation (P>0.05). The excellent and good rates of Mac Nab standard grading in the observation group and the control group were 93.88% and 91.84%,respectively; the difference was not statistically significant (P>0.05). There were no significant complications in both groups (P>0.05). 【Conclusion】 The effect of percutaneous foraminal endoscopic TESSYS in the treatment of senile lumbar disc herniation is positive. It can significantly improve MRI performance and quality of life. It has the advantages of less trauma and rapid postoperative recovery.
Key wordsIntervertebral Disc Displacement/SU    Diskectomy,Percutaneous    Quality of Life    Treatment Outcome
收稿日期: 2022-06-20     
中图分类号:  R681.53  
通讯作者: * E-mail:1241620818@qq.com   
引用本文:   
李龙, 郭一帆. 经皮椎间孔镜下TESSYS技术治疗老年腰椎间盘突出的效果及对MRI指标和生活质量的影响[J]. 医学临床研究, 2023, 40(4): 515-518.
LI Long, GUO Yi-fan. Application of TESSYS Technique under Percutaneous Foraminal Endoscopy in the Treatment of Senile Lumbar Disc Herniation and its Effects on MRI Indexes and Life Quality. JOURNAL OF CLINICAL RESEARCH, 2023, 40(4): 515-518.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.04.010     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I4/515
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