|
|
|
| Clinical Effect of Percutaneous Spinal Endoscopic Translaminar Approach in the Treatment of Lumbar Instability with Lumbar Disc Herniation |
| ZHANG Bing, MA Hang |
| Department of Spine Surgery, Xianyang Central Hospital, Xianyang Shaanxi 712000 |
|
|
|
|
Abstract 【Objective】To investigate the clinical effect of percutaneous spinal endoscopic translaminar approach in the treatment of lumbar instability with lumbar disc herniation.【Methods】A retrospective analysis was performed on 164 patients with lumbar instability with lumbar disc herniation (group A) who underwent percutaneous spinal endoscopic translaminectomy in our hospital from May 2019 to May 2022, and 97 patients (group B) who underwent routine open surgery in our hospital during the same period. The preoperative and postoperative lumbar pain [visual analogue scale (VAS)], the degree of lumbar dysfunction [Oswestry Disability Index (ODI)], the therapeutic effect and the incidence of complications were compared between the two groups.【Results】There was no significant difference in preoperative VAS and ODI scores between the two groups (P>0.05). VAS scores and ODI scores of back and leg pain 1 d, 1 month and 3 months after surgery and ODI scores of 12 months after surgery between the two groups had statistical significance (P<0.05), while VAS scores of back and leg pain 12 months after surgery had no statistical significance between the two groups (P>0.05). VAS scores and ODI scores in the group A were lower than those in the group B at 1 day, 1 month and 3 months after surgery, and ODI scores at 12 months after surgery. 12 months after operation, the curative effect of the group A was better than that of the group B (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05).【Conclusion】Compared with conventional open surgery, percutaneous spinal endoscopic translaminar approach for the treatment of patients with lumbar instability and lumbar disc herniation has significant clinical efficacy, can improve the pain degree of patients and lumbar rehabilitation effect, and has good safety.
|
|
Received: 09 May 2024
|
|
|
|
|
|
[1] 李展奇,王贺,谢昌达,等. 经皮全脊柱内镜下椎间孔入路和椎板间入路减压术治疗L5～S1侧隐窝狭窄的临床疗效比较[J].西安交通大学学报(医学版),2022,43(1):154-158.
[2] ZHANG A S, XU A, ANSARI K, et al. Lumbar disc herniation: diagnosis and management[J].Am J Med,2023,136(7):645-651.
[3] 赵金龙. 经皮椎板间入路全脊柱内镜手术治疗L5~S1节段钙化型腰椎间盘突出症27例[J].颈腰痛杂志,2019,40(4):520-522.
[4] 孙凤龙,梁庆晨,王宏庆,等. 脊柱内镜下经椎间孔腰椎椎间融合术治疗腰椎间盘突出症伴腰椎不稳的早期临床研究[J].中华骨与关节外科杂志,2019,12(10):754-760.
[5] 张智,刘元彬,郑佳状,等. 经皮脊柱内镜经椎板入路治疗向上重度游离型腰椎间盘突出症的临床研究[J].中国骨与关节杂志,2023,12(1):76-79.
[6] 中华医学会疼痛学分会脊柱源性疼痛学组. 腰椎间盘突出症诊疗中国疼痛专家共识[J].中国疼痛医学杂志,2020,26(1):2-6.
[7] 何彪,李世伟,谢永波,等. 脊柱内镜辅助斜外侧椎间融合术与经椎间孔腰椎椎体间融合术治疗腰椎不稳伴腰椎间盘突出症的疗效观察[J].中国内镜杂志,2023,29(1):29-37.
[8] 王善坤,柳申鹏,杨利斌,等. 经皮脊柱内镜椎板间入路手术治疗腰椎管狭窄症的临床疗效分析[J].中国骨与关节损伤杂志,2022,37(5):512-514.
[9] 薛静波,陈浩翔,李学林,等. 经皮全脊柱内镜经椎板间隙入路治疗中央型腰椎管狭窄症[J].中国微创外科杂志,2020,20(4):322-325.
[10] PAN M M, LI Q F, LI S C, et al. Percutaneous endoscopic lumbar discectomy: indications and complications[J].Pain Physician,2020,23(1):49-56.
[11] 郑琎喆,李伍建,赵金龙,等. 经椎间孔入路与椎板间入路脊柱内镜下治疗老年椎间盘突出症疗效及对VAS、JOA评分的影响[J].解放军医药杂志,2020,32(7):72-75.
[12] 中国康复技术转化及发展促进会骨科加速康复专业委员会脊柱微创加速康复学组. 经皮内镜椎板间入路腰椎管减压椎间盘切除术加速康复专家共识(2020)[J].中国修复重建外科杂志,2020,34(12):1497-1506.
[13] 严小林,陈彦,陈永华,等. 经皮内窥镜下经椎间孔入路腰椎椎间融合术治疗腰椎椎管狭窄症[J].脊柱外科杂志,2022,20(6):385-389.
[14] 梁庆晨,孙凤龙,王宏庆,等. 经皮脊柱内镜椎板间隙入路治疗微小腰椎间盘突出症的短期临床观察[J].中国内镜杂志,2023,29(3):31-36.
[15] 卢生伟,贺新宁,杜志勇. 三种术式治疗腰椎间盘突出症的近远期疗效分析[J].中国临床医生杂志,2023,51(5):588-592.
[16] 花奔,花艮春,段黄强,等. 经皮内镜椎板间入路椎间盘切除术治疗腰椎间盘突出症[J].临床骨科杂志,2023,26(3):323-327. |
|
|
|
2024, Vol. 41 
