[1]黄保华 陈远明** 周先明 黄民锋 陈锋 温永福 万健.经椎间孔经皮内镜治疗复发性腰椎间盘突出症[J].中国微创外科杂志,2016,16(09):820-832.
　Huang Baohua,Chen Yuanming,Zhou Xianming,et al.Efficacy of Percutaneous Transforaminal Microendoscopy Discectomy for Recurrent Lumbar Disc Herniation[J].Chinese Journal of Minimally Invasive Surgery,2016,16(09):820-832.
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经椎间孔经皮内镜治疗复发性腰椎间盘突出症()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
16
期数:
2016年09期
页码:
820-832
栏目:
临床研究
出版日期:
2016-09-09

文章信息/Info

Title:
Efficacy of Percutaneous Transforaminal Microendoscopy Discectomy for Recurrent Lumbar Disc Herniation
作者:
黄保华 陈远明** 周先明 黄民锋 陈锋 温永福 万健
（广西中医药大学附属瑞康医院脊柱微创外科，南宁530011）
Author(s):
Huang Baohua;  Chen Yuanming;  Zhou Xianming;  et al.
Department of Spine Minimally Invasive Surgery, Ruikang Hospital of Guangxi Traditional Chinese Medical University, Nanning 530011, China
关键词:
复发性腰椎间盘突出症; 椎间孔镜
Keywords:
Recurrent lumbar disc herniation; Transforaminal microendoscopy
文献标志码:
A
摘要:
目的探讨经椎间孔经皮内镜治疗复发性腰椎间盘突出症的早期疗效。方法2011年10月～2014年6月我科对32例复发性腰椎间盘突出症采用经椎间孔经皮内镜腰椎间盘切除术，采用腰腿痛VAS评分、Oswestry功能障碍指数（Oswestry disability index,ODI）和改良MacNab疗效标准评定评价早期疗效。结果32例术后随访12～26个月，术前腰痛VAS（7.2±2.1）分，术后3个月（2.9±1.8）分，差异有统计学意义(q=14.325,P＜0.05)，术后1年（2.3±1.0）分，与术后3个月比较差异无统计学意义(q=1.999,P＞0.05);改善率（75.8±12.4）%。术前腿痛VAS评分中位数9.1分(4.1~9.9分)，术后3个月中位数2.4分（1.5~4.0分），差异有统计学意义(Z=-4.937,P=0.000)，术后1年中位数2.1分(1.2~3.0分)，与术后3个月比较差异无统计学意义(Z=-1.609,P=0.108)；改善率（72.1±10.2）%。ODI术前55.4±10.2，术后3个月22.6±6.2，术后1年8.5±5.3，差异有统计学意义(F=325.90，P=0.000)；改善率（86.8±10.2）%。改良MacNab疗效评定标准：优14例，良12例，可4例,差2例，优良率81.2％（26/32）。结论经椎间孔经皮内镜治疗复发性腰椎间盘突出症疗效满意。
Abstract:
ObjectiveTo discuss the efficacy of percutaneous transforaminal microendoscopy discectomy in the treatment of recurrent lumbar disc herniation.MethodsA total of 32 cases of recurrent lumbar disc herniation underwent percutaneous transforaminal microendoscopy discectomy by the same surgical team from October 2011 to June 2014. Early effects were observed by using the VAS scales of lower back pain and leg pain, the Oswestry disability index (ODI), and the modified MacNab criteria. ResultsAll the cases were followed up for 12-26 months. The lower back pain VAS scores were (7.2±2.1), (2.9±1.8), and (2.3±1.0) points at preoperative, 3 month postoperative and 1 year postoperative time, respectively. There was statistical significance between preoperative and 3 month postoperative scores (q=14.325, P＜0.05), while no statistical significance was seen between 3 month postoperative and 1 year postoperative (q=1.999, P＞0.05). The average improvement rate was (75.8±12.4)%. The preoperative, 3 month postoperative and 1 year postoperative leg pain VAS scores (median) were 9.1, 2.4, and 2.1 points, respectively. There was statistical significance between preoperative and 3 month postoperative scores (Z=-4.937, P=0.000), while no statistical significance between 3 month postoperative and 1 year postoperative scores was seen (Z=-1.609, P=0.108). The average improvement rate was (72.1±102)%. The preoperative, 3 month postoperative and 1 year postoperative ODIs were 554±10.2, 22.6±6.2, and 8.5±5.3, respectively, with statistically significant difference (F=325.90, P=0.000). The average improvement rate was (86.8±10.2)%. The modified MacNab efficacy evaluation showed excellent in 14 patients, good in 12 patients, fair in 4 patients, and poor in 2 patients, the excellent and good rate being 81.2％ (26/32). ConclusionThe posterior microendoscopy discectomy can achieve satisfactory clinical results in treating recurrent lumbar disc herniation.

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备注/Memo

备注/Memo:
基金项目：广西教育厅中青年教师基础能力提升项目资助（项目编号：KY2016YX148）**通讯作者，Email：rkyygk@163.com
更新日期/Last Update: 2016-12-09