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靶向椎间孔成型技术在腰椎内镜中的应用

Technique of targeted foraminoplasty in percutaneous endoscopic lumbar discectomy
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摘要 [目的]探讨靶向椎间孔成型技术在经皮内镜下腰椎间盘切除术(PELD)中的近期临床应用疗效。[方法]回顾性分析2017年9月~2018年3月于本院应用经皮内镜靶向椎间孔成型技术治疗并获得随访的28例腰椎间盘突出症(LDH)患者的临床资料,采用VAS评分评价手术疗效、ODI评分评估腰椎功能,采用改良Macnab评分标准评价手术优良率。[结果]所有28例患者均在局麻下顺利完成PELD,手术时间25~90min;出血量10~25ml,术中透视次数8~15次,住院时间4~7d。无神经损伤、硬膜撕裂和切口感染等早期并发症发生。所有患者随访7~12个月,平均(9.30±2.28)个月;术后各时间点腰痛VAS评分、腿痛VAS评分及ODI评分均较术前改善,差异具有统计学意义(P<0.05)。根据改良Macnab评分标准评定优良率,优18例,良8例,可1例,差1例,优良率为92.86%。[结论]经皮内镜靶向椎间孔成型技术疗效确切,安全性高,有效地降低PELD的学习曲线,减少了透视次数,值得推广应用。 [Objective]To explore the short-term outcome of targeted foraminoplasty in percutaneous endoscopic lumbar discectomy(PELD).[Methods]A retrospective study was conducted on 28 patients who underwent targeted foraminoplasty in PELD for lumbar disc herniation from September 2017 to March 2018 in our institution.Their clinical outcomes were evaluated with Visual Analogue Scale(VAS)for leg pain and back pain score,Oswestry disability index(ODI),modified MacNab's criteria as well.[Results]All patients received successful surgical procedures with operation time of 25~90 min,intraoperative blood loss of 10~25 ml,frequency of fluoroscopy of 8~15 times,and hospital stay of 4 to 7 d.No serious complications happened in any of them,such as nerve injury,dural tear and infection.All of them were followed up for 7~12 months with an average of(9.30±2.28)months.Both the VAS and ODI scores significantly decreased postoperatively compared with those before operative,with statistically significant differences(P<0.05).In term of Modified MacNab's criteria,the clinical results were graded as excellent in 18,good in 8,fair in 1 and poor in 1.[Conclusion]This targeted foraminoplasty in PELD is an effective and safe treatment for lumbar disc herniation with advantages of reducing the difficulty in PELD and minimizing radiation exposure.
作者 伍搏宇 徐峰 康辉 熊承杰 谭林英 WU Bo-yu;XU Feng;KANG Hui;XIONG Cheng-jie;TAN Lin-ying(Graduate Institute,Hubei University of Chinese Medicine,Wuhan 430070,China;Orthopedic Department,General Hospital of PLA Central Theater,Wuhan430000,China)
出处 《中国矫形外科杂志》 CAS CSCD 北大核心 2019年第15期1350-1354,共5页 Orthopedic Journal of China
基金 湖北省卫生和计划生育委员会科研项目(编号:WJ2017H0033) 全军医学科技青年培育计划项目(编号:18QNP054) 国家自然科学基金项目(编号:81401802).
关键词 靶向椎间孔成型技术 腰椎间盘突出症 经皮内镜下腰椎间盘切除术 technique of targeted foraminoplasty lumbar disc herniation percutaneous endoscopic lumbar discectomy
作者简介 伍搏宇,住院医师,在读硕士研究生,研究方向:脊柱微创外科,(电话)18064108820,(电子信箱)wuboyuspine@163.com;通信作者:徐峰,(电话)13397191978,(电子信箱)gkxf79390@sohu.com.
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