临床外科杂志 ›› 2019, Vol. 27 ›› Issue (1): 72-75.doi: 10.3969/j.issn.1005-6483.2019.01.021

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经皮椎间孔镜与Quadrant微创通道下治疗单节段腰椎间盘突出症临床疗效比较

  

  1. 武汉大学中南医院脊柱外科一病区
  • 出版日期:2019-01-20 发布日期:2019-01-20
  • 通讯作者: 金伟,Email:907821033@qq.com

Comparison of the clinical efficacy of percutaneous transforminal endoscopic discectomy and Quadrant minimally invasive system in treatment of the single segment of lumbar disc herniation

  1. Department of Orthopaedics Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China
  • Online:2019-01-20 Published:2019-01-20

摘要: 目的 比较经皮椎间孔镜(PTED)和Quandrant微创通道下治疗单节段腰椎间盘突出症(LDH)的临床疗效。方法 单节段LDH病人74例,按手术方式不同将病人分为两组,PTED组45例,采用经皮椎间孔镜下治疗;Quadrant微创通道组29例,采用Quandrant微创通道下治疗,比较两组手术时间、失血量、切口长度、卧床休息时间、住院时间、手术并发症。采用视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科学会下腰痛评分标准(JOA)评分以及改良MacNab标准对手术疗效评价疗效。结果 PTED组手术时间为(79.5±9.5)分钟,术中失血量为(18.6±3.4)ml,手术切口长度(0.8±0.1)cm、卧床休息时间(1.5±0.7)天、住院时间(5.3±1.0)天、术后3天腰痛VAS评分(2.9±0.6)分,Quadrant组分别为(70.3±8.7)分钟、(44.9±4.6)ml、(4.5±0.3)cm、(3.4±0.6)天、(8.0±0.8)分,两组比较差异有统计学意义(P<0.05);术后1、3、6和12 个月两组ODI、JOA及改良MacNab标准比较无统计学意义(P>0.05)。结论 PTED与Quadrant微创通道治疗单节段LDH疗效无明显差异,但PTED手术组出血少,创伤小,术后恢复快。

关键词: 经皮椎间孔镜, Quadrant微创通道, 腰椎键盘突出症

Abstract: Objective To compare the clinical efficacy of percutaneous transforaminal endos-copic discectomy(PTED) and Quadrant minimally invasive system in treatment of the single segment of lumbar disc herniation(LDH). In order to provide a safe and effective surgical method for the treatment of single segment lumbar disc herniation.Methods 74 cases of patients with single lumbar disc herniation treated were retrospectively reviewed, The patients were divided into two groups according to the operation methods.45 patients were treated by PTED(PTED group) and 29 patients were treated by Quadrant minimally invasive system(Quadrant group).Compare the operative time, blood loss,incision length, the time of bed rest,length of hospital stay and intraoperative complications between the two groups. Visual analogue scale(VAS), Oswestry disability index(ODI), Japanese orthopedic Association (JOA) and modified MacNab criteria were used for surgical efficacy evaluation.Result The operation time was (79.5±9.5)min,blood loss was(18.6±3.4)ml, incision length was(0.8±0.1)cm,the time of bed rest was(1.5±0.7)d,length of hospital stay was (5.3±1.0)d,the VAS score in three days after operation was(2.9±0.6) ,which were shorter or lower in PTED group compared with the Quadrant group[(70.3±8.7)min,(44.9±4.6)ml,(4.5±0.3)cm,(3.4±0.6)d,(8.0±0.8)](all P<0.05).The operation time were shorter in Quadrant group(70.3±8.7) compared with the PTED group(79.5±9.5)(P<0.05); The postoperative ODI、JOA and MacNab criteria excellent rate had no significant difference between the two groups(P>0.05).Conclusion Both PTED and Quadrant minimally invasive system are effective in the treatment the single segment of LDH.Comparatively,PTED were less bleeding,short incision length, rapid recovery. It will be a good choice for the treatment of single segment lumbar disc herniation.

Key words: percutaneous transforaminal endoscopic discectomy, Quadrant minimally invasive system, lumbar disc herniation

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