[1]姜宇 袁磊 郭昭庆* 李危石 陈仲强 齐强 曾岩 孙垂国 钟沃权 孙卓然.经椎间孔腰椎椎体间融合术治疗经皮内镜腰椎间盘切除术后复发性单节段腰椎间盘突出症[J].中国微创外科杂志,2021,01(1):41-46.
　Jiang Yu,Yuan Lei,Guo Zhaoqing,et al.Transforaminal Lumbar Interbody Fusion for Lumbar Revision Surgery After Percutaneous Endoscopic Lumbar Discectomy of Singlesegment Lumbar Disc Herniation[J].Chinese Journal of Minimally Invasive Surgery,2021,01(1):41-46.
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经椎间孔腰椎椎体间融合术治疗经皮内镜腰椎间盘切除术后复发性单节段腰椎间盘突出症()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年1期
页码:
41-46
栏目:
临床研究
出版日期:
2021-02-26

文章信息/Info

Title:
Transforaminal Lumbar Interbody Fusion for Lumbar Revision Surgery After Percutaneous Endoscopic Lumbar Discectomy of Singlesegment Lumbar Disc Herniation
作者:
姜宇 袁磊 郭昭庆* 李危石 陈仲强 齐强 曾岩 孙垂国 钟沃权 孙卓然
（北京大学第三医院骨科脊柱疾病研究北京市重点实验室，北京100191）
Author(s):
Jiang Yu;  Yuan Lei;  Guo Zhaoqing;  et al.
Department of Orthopeadics, Peking University Third Hospital, Beijing Key Laboratory of Spinal Disease Research, Beijing 100191, China
关键词:
经皮内镜腰椎间盘切除术; 经椎间孔腰椎椎体间融合术; 经椎间孔入路经皮内镜椎间盘切除术; 经椎板间入路经皮内镜椎间盘切除术; 复发性腰椎间盘突出症; 翻修手术
Keywords:
Percutaneous endoscopic lumbar discectomy; Transforminal lumbar interbody fusion; Percutaneous endoscopic transforaminal discectomy; Percutaneous endoscopic interlaminar discectomy; Recurrent lumbar disc herniation; Revision surgery
文献标志码:
A
摘要:
目的探讨经椎间孔腰椎椎体间融合术（transforaminal lumbar interbody fusion，TLIF）治疗经皮内镜腰椎间盘切除术(percutaneous endoscopic lumbar discectomy，PELD)后复发性单节段腰椎间盘突出症（lumbar disc herniation，LDH）的临床疗效。方法回顾性分析我院2014 年1 月~2018 年12 月46例PELD术后复发性单节段LDH行TLIF治疗的临床资料，其中初次行经椎间孔入路经皮内镜椎间盘切除术(percutaneous endoscopic transforaminal discectomy，PETD) 31例（PETD组），初次行经椎板间入路经皮内镜椎间盘切除术(percutaneous endoscopic interlaminar discectomy，PEID) 15例（PEID组）。观察2组手术时间、术中出血量、术后引流量、围术期血红蛋白和血细胞比容水平、围术期并发症和随访情况等。结果PETD组翻修术中出血量（239.7±91.8）ml，PEID组（235.3±47.9）ml；PETD组翻修术后引流量（483.4±248.0）ml，PEID组（342.7±99.0）ml。翻修手术时5例发生脑脊液漏，均发生在PETD组。PETD组7例（22.6%）术后出现一过性神经功能加重，PEID组仅2例（13.3%）。46例术后随访（34.8±9.2）月，末次随访所有患者均未出现症状复发和再次翻修手术,腰腿痛视觉模拟评分(Visual Analogue Score，VAS)、日本骨科学会 (Japanese Orthopedic Association，JOA)29分法评分和Oswestry功能障碍指数 (Oswestry Disability Index，ODI)均较术前明显改善（均P=0.000），PEID、PETD组改良MacNab疗效评定优良率分别为93.3%（14/15）、93.5%（29/31）。结论TLIF治疗PELD术后复发性单节段LDH疗效可靠。
Abstract:
ObjectiveTo evaluate the clinical efficacy of transforaminal lumbar interbody fusion (TLIF) in the treatment of recurrent singlesegment lumbar disc herniation(LDH) after percutaneous endoscopic lumbar discectomy(PELD).MethodsA retrospective analysis was performed on the clinical data of 46 patients admitted to our department from January 2014 to December 2018 who underwent TLIF for recurrent singlesegment LDH after PELD. There were 31 cases of percutaneous endoscopic transforaminal discectomy (PETD group) and 15 cases of percutaneous endoscopic interlaminar discectomy (PEID group). The operative time, intraoperative blood loss, postoperative drainage volume, perioperative hemoglobin and hematocrit levels, perioperative complications and followup records were counted. Results The intraoperative blood loss was (239.7±91.8) ml in the PETD group and (235.3±479) ml in the PEID group. The postoperative drainage volume was (483.4±248.0) ml in the PETD group and (342.7±990) ml in the PEID group.Cerebrospinal fluid leakage occurred in 5 patients during revision surgery, all of them occurred in the PETD group. Transient neurological deterioration occurred in 7 patients (22.6%) in the PETD group and only 2 patients (13.3%) in the PEID group. The 46 patients were followed up for (34.8±9.2) months. Up to the last followup, all the patients had no recurrence of symptoms or repeated revision surgery. The VAS, JOA29 scores and ODI of lumbocrural pain were significantly improved (all P=0000). The excellent and good rates of modified MacNab criteria in the PEID group and PETD group were 933%(14/15) and 93.5%(29/31) respectively.ConclusionTLIF has a reliable efficacy in the treatment of patients with recurrent singlesegment LDH after PELD.

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备注/Memo

备注/Memo:
*通讯作者，Email:gzq6698@sina.com
更新日期/Last Update: 2021-04-02