[1]宋晓磊 王红建 黄鹏博 吴志朋*.经皮内镜椎板间开窗与椎间孔入路治疗腰椎间盘突出症的比较[J].中国微创外科杂志,2021,01(5):405-409.
　Song Xiaolei,Wang Hongjian,Huang Pengbo,et al.Comparison of Percutaneous Endoscopic Fenestration Discectomy and Transforaminal Discectomy for Lumbar Disc Herniation[J].Chinese Journal of Minimally Invasive Surgery,2021,01(5):405-409.
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经皮内镜椎板间开窗与椎间孔入路治疗腰椎间盘突出症的比较()
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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5期
页码:
405-409
栏目:
临床研究
出版日期:
2021-05-25

文章信息/Info

Title:
Comparison of Percutaneous Endoscopic Fenestration Discectomy and Transforaminal Discectomy for Lumbar Disc Herniation
作者:
宋晓磊 王红建 黄鹏博 吴志朋*
（安钢总医院脊柱微创外科，安阳455000）
Author(s):
Song Xiaolei;  Wang Hongjian;  Huang Pengbo;  et al.
Department of Minimally Invasive Spinal Surgery, Angang General Hospital, Anyang 455000, China
关键词:
经皮内镜; 腰椎间盘突出症; 椎间盘切除术; 椎板间开窗; 椎间孔镜
Keywords:
Percutaneous endoscopy; Lumbar disc herniation; Discectomy; Fenestration discectomy; Transforaminal endoscopy
文献标志码:
A
摘要:
目的比较经皮内镜椎板间开窗椎间盘切除术（percutaneous endoscopic fenestration discectomy，PEFD）与椎间孔入路椎间盘切除术(percutaneous endoscopic transforaminal discectomy，PETD)治疗腰椎间盘突出症的临床疗效。方法回顾性分析2017年3月~2018年10月145例腰椎间盘突出症的临床资料，患者选择手术方式，其中PEFD 73例，PETD 72例。2组年龄、性别、手术节段、突出类型差异无统计学意义（P>0.05）。比较2组手术时间、术中出血量、术中透视次数、住院时间、手术并发症、术后卧床时间。比较2组术前、术后1个月、末次随访腰腿痛视觉模拟评分(Visual Analogue Scale,VAS)、Oswestry功能障碍指数(Oswestry Disability Index,ODI)。改良MacNab标准评估末次随访时的临床疗效。结果与PETD组相比，PEFD组手术时间短［（88.0±11.7）min vs.（111.7±14.2）min,t=-10.992,P=0.000］，但透视次数多［（28.4±4.0）次vs.（7.1±1.1）次,t=44.023,P=0.000］。2组术中出血量、术后卧床时间、住院时间、并发症差异无统计学意义（P>0.05）。2组随访时间差异无统计学意义［（25.3±3.9）月vs.（24.6±2.5）月,t=1.340,P=0.183］。2组术后1个月、末次随访VAS评分、ODI均较术前明显改善（P<0.05），2组间比较差异无统计学意义（P>0.05）。末次随访改良MacNab标准优良率，PEFD组为90.4%（66/73），PETD组为87.5%（63/72）（χ2=0.313，P=0.576）。结论PEFD可以取得与PETD相似的临床疗效，且可缩短手术时间。
Abstract:
ObjectiveTo evaluate the clinical results of percutaneous endoscopic fenestration discectomy (PEFD) and percutaneous endoscopic transforaminal discectomy (PETD) for lumbar disc herniation (LDH).MethodsA total of 145 patients with LDH from March 2017 to October 2018 were retrospectively included. And the patients were divided into the PEFD group (n=73) or PETD group (n=72) according to their choice of different surgical methods. No significant differences in age, gender, surgical segment, herniation type were found between the two groups (P>0.05). The operation time, intraoperative blood loss, fluoroscopy times, and surgical complications were compared. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were compared preoperatively, 1 month postoperatively, and at the final followup between the two groups. The modified MacNab criteria at the final followup was used to evaluate clinical effectiveness.ResultsThe operation time of the PEFD group was significantly shorter compared with the PETD group ［(88.0±11.7) min vs. (111.7±14.2) min, t=-10.992, P=0.000］. However, the fluoroscopy times of the PEFD group was significantly more than the PETD group ［(28.4±4.0) times vs. (7.1±1.1) times, t=44023, P=0.000］. There were no significant differences in intraoperative blood loss, bed rest time, length of hospital stay, and complications between the two groups (P>0.05). No significant difference was found in followup time between the two groups ［(253±3.9) month vs. (24.6±2.5) month, t=1.340, P=0.183］. The VAS score and ODI at 1 postoperative month and finial followup were significantly improved over the preoperative scores in both groups (P<0.05). There were no significant differences in postoperative VAS and ODI between the two groups (P>0.05). There were no significant differences in excellent and good rate between the PEFD group (90.4%, 66/73) and the PETD group (87.5%, 63/72) at the final followup (χ2=0.313, P=0.576).ConclusionPEFD has a similar clinical effect with PETD in the treatment of LDH, with less operation time.

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备注/Memo

备注/Memo:
*通讯作者，Email：wuzhipeng3616@163.com
更新日期/Last Update: 2021-08-06