显微镜和椎间孔镜下腰椎间盘切除术治疗腰椎间盘突出症的临床疗效<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2024.01.006

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Abstract 【Objective】 To investigate the efficacy and safety of microsurgical lumbar discectomy (MSLD) and percutaneous endoscopic lumbar discectomy (PELD)in the treatment of lumbar disc herniation. 【Methods】 A total of 486 patients with lumbar disc herniation undergoing minimally invasive surgery at Loudi Central Hospital from December 2013 to May 2022 were retrospectively analyzed. Among them, 192 patients underwent MSLD treatment (the MSLD group) and 294 patients underwent PELD (the PEID group). The pain visual simulation scores (visual analogue scale, VAS), the muscle strength score (manual muscle testing, MMT) at 1 week, 3 months, 6 months, 12 months and 24 months after surgery and complication rates were compared between the two groups. 【Results】 The VAS scores of the two groups at each time point after surgery were significantly lower than those before surgery(P<0.05); however, there were no statistically significant differences in the VAS scores at each time point before and after treatment between the two groups (P>0.05). The MMT scores of the two groups of patients at each time point after surgery were significantly higher than those before surgery(P<0.05); however, there were no statistically significant differences in the MMT scores at each time point before and after treatment between the two groups (P>0.05).The total complication rate in the MSLD group was 2.60%(5/192), which was significantly lower than the 8.50%(25/294) in the PELD group, and the difference was statistically significant (P<0.05). 【Conclusion】 Both MSLD and PELD can effectively reduce the pain of patients with lumbar disc herniation. PELD is operated under local anesthesia, which can check the muscle strength of lower limbs, the feedback of pain and numbness during the operation. Its warning effect can reduce nerve damage and reduce the incidence of complications.

Key words： Intervertebral Disc Displacement/SU Lumbar Vertebrae/SU Diskectomy Treatment Outcome

Received: 02 December 2022

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R681.53

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2024.01.006 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2024/V41/I1/22

[1] 贾连顺. 脊柱外科学[M]. 上海:第二军医大学出版社, 2009:220-230.
[2] WU J, YU B, HE B, et al. Outcome predictors of the transforaminal endoscopic spine system technique for single-level lumbar disk herniation[J].J Neurol Surg A Cent Eur Neurosurg,2018, 79(4):285-290.
[3] 余洋, 谭彪, 谢一舟, 等.椎间孔镜下可视化椎间孔成形术治疗腰椎间盘突出症的安全性及临床疗效分析[J].重庆医学, 2019, 48(6):960-964.
[4] 张明会,李惠萍,黄春霞. 刺形按摩球分心干预对局麻椎间孔镜术患者术中疼痛和焦虑的影响[J].中国实用护理杂志,2021, 37 (11):844-849.
[5] CONABLE K M, ROSNER A L. A narrative review of manual muscle testing and implications for muscle testing research[J].J Chiropr Med,2011, 10(3):157-165.
[6] 朱文刚,朱李贞,张志鹏,等.显微镜辅助通道下腰椎间盘髓核摘除术治疗腰椎间盘突出症的效果[J].中国医药导报,2019,16(18):77-80.
[7] AHN Y. Transforaminal percutaneous endoscopic lumbar discectomy: technical tips to prevent complications[J].Expert Rev Med Devices,2012, 9(4):361-366.
[8] PAN M, LI Q, LI S, et al. Percutaneous endoscopic lumbar discectomy: indications and complications[J].Pain Physician,2020, 23(1):49-56.
[9] SKOLASKY R L, WEGENER S T, MAGGARD A M, et al.The impact of reduction of pain after lumbar spine surgery[J].Spine,2014, 39(17):1426-1432.
[10] 温冰涛, 张西峰, 王岩, 等. 经皮内窥镜治疗腰椎间盘突出症的并发症及其处理[J].中华外科杂志, 2011,49(12):1091-1095.
[11] 楚磊, 晏铮剑, 陈亮, 等. 不同体位下经皮椎间孔镜手术治疗腰椎间盘突出症的比较[J].中国脊柱脊髓杂志, 2011, 21(2):166-167.
[12] 张淋霖, 秦国良. 经椎板间入路椎间孔镜下椎间盘切除术与开放手术治疗腰椎间盘突出症疗效比较[J].医学临床研究, 2022, 39(1):26-29.
[13] 张芳芳. 侧路椎间孔镜髓核摘除治疗腰椎间盘突出的效果和安全性分析[J].医学临床研究, 2018, 35(12):2395-2397.
[14] 李莹, 唐谨, 吴从俊, 等. 椎间孔镜治疗椎间隙塌陷的腰椎间盘突出症预防出口神经损伤的措施[J].生物骨科材料与临床研究, 2022, 19(1):67-70.

[1]	. [J]. JOURNAL OF CLINICAL RESEARCH, 2024, 41(2): 296-298.