[1]李 涛 张同会 谢 维 李 莹 吴从俊 刘 鏐 唐 谨 李绪贵.可视化环锯辅助下椎间孔镜技术治疗脱出游离型腰椎间盘突出症[J].中国临床神经外科杂志,2020,(09):597-599.[doi:10.13798/j.issn.1009-153X.2020.09.007]
 LI Tao,ZHANG Tong-hui,XIE Wei,et al.Visual circular saw-assisted percutaneous transforaminal endoscopic discectomy for patients with prolapsed free lumbar disc herniation[J].,2020,(09):597-599.[doi:10.13798/j.issn.1009-153X.2020.09.007]
点击复制

可视化环锯辅助下椎间孔镜技术治疗脱出游离型腰椎间盘突出症()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年09期
页码:
597-599
栏目:
论著
出版日期:
2020-09-20

文章信息/Info

Title:
Visual circular saw-assisted percutaneous transforaminal endoscopic discectomy for patients with prolapsed free lumbar disc herniation
文章编号:
1009-153X(2020)09-0597-03
作者:
李 涛 张同会 谢 维 李 莹 吴从俊 刘 鏐 唐 谨 李绪贵
430079 武汉,湖北六七二中西医结合骨科医院脊柱微创科(李 涛、张同会、谢 维、李 莹、吴从俊、刘 鏐、唐 谨、李绪贵)
Author(s):
LI Tao ZHANG Tong-hui XIE Wei LI Ying WU Cong-jun LIU Liu TANG Jin LI Xu-gui.
Department of Minimally Invasive Spinal Surgery, Hubei 672 Orthopaedics Hospital of Integrated Chinese and Western Medicine, Wuhan 430079, China
关键词:
腰椎间盘突出症可视化环锯辅助下椎间孔镜技术疗效
Keywords:
Lumbar disc herniation Visual circular saw-assisted percutaneous transforaminal endoscopic discectomy Efficacy
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2020.09.007
文献标志码:
R 681.5+7
摘要:
目的 探讨可视化环锯辅助下椎间孔镜技术(VPTED)治疗脱出游离型腰椎间盘突出症(LDH)的疗效。方法 回顾性分析2017年6月至2019年4月VPTED治疗的37例脱出游离型LDH的临床资料。手术前后采用视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)及日本骨科协会(JOA)评分评估手术疗效,末次随访改良MacNab标准评定疗效。结果 1例因高髂嵴及腰5横突肥大,置管困难,最终选择实施椎板间入路椎间孔镜手术;其余36例均顺利完成手术。术后随访12~24个月,平均为(18.25±6.44)个月;1例术后8个月出现同节段复发,予以内固定融合手术治疗;37例术后VAS 评分、ODI 及 JOA 评分较术前均明显改善(P<0.05)。末次随访改良MacNab标准评价临床疗效:优26例,良8例,可2例,差 1例;优良率为91.89(34/37)。结论 VPTED治疗脱出游离型LDH疗效确切,手术并发症少,操作简便、安全
Abstract:
Objective To explore the effect of visual circular saw-assisted percutaneous transforaminal endoscopic discectomy (VPTED) on the patients with prolapsed free lumbar disc herniation (LDH). Methods The clinical data of 37 patients with prolapsed free LDH underwent VPTED from June 2017 to April 2019 were retrospectively analyzed. Visual analog scale (VAS) score, Oswestry disability index (ODI) and Japan Orthopaedic Association (JOA) score were used to evaluate the efficacy before and after surgery. The modified MacNab standard was used to evaluate the clinical efficacy at the last follow-up. Results One patient was difficult to insert the tube due to hypertrophy of the high iliac crest and lumbar 5 transverse process, and finally chosen to perform interlaminar foraminal surgery, and the other 36 patients successfully completed the operation. The postoperative follow-up ranged from 12 to 24 months, with an average of (18.25±6.44) months; 1 patient had recurrence at the same level 8 months after the operation and was treated with internal fixation and fusion surgery. The postoperative VAS score, ODI and JOA score were significantly improved compared with those preoperatively (P<0.05). The modified MacNab criteria evaluated the clinical efficacy at the last follow-up: 26 patients were excellent, 8 good, 2 fair, and 1 poor; the excellent and good rate was 91.89 (34/37). Conclusion VPTED is an effective method for the treatment of patients with prolapsed free LDH, with few surgical complications, and simple and safe procedure

参考文献/References:

[1] Yu P, Qiang H, Zhou J, et al. Percutaneous transforaminal endoscopic discectomy versus micro-endoscopic discec- tomy for lumbar disc herniation [J]. Med Sci Monit, 2019, 25: 2320-2328.
[2] Pan M, Li Q, Li S, et al. Percutaneous endoscopic lumbar discectomy: indications and complications [J]. Pain Physi- cian, 2020, 23(1): 49-56.
[3] Kim HS, Paudel B, Jang JS, et al. Percutaneous endoscopic lumbar discectomy for all types of lumbar disc herniations (ldh) including severely difficult and extremely difficult LDH cases [J]. Pain Physician, 2018, 21(4): E401-E408.
[4] Qin R, Liu B, Hao J, et al. Percutaneous endoscopic lumbar discectomy versus posterior open lumbar microdiscectomy for the treatment of symptomatic lumbar disc herniation: a systemic review and meta-analysis [J]. World Neurosurg, 2018, 120: 352-362.
[5] Liu C, Chu L, Yong HC, et al. Percutaneous endoscopic lumbar discectomy for highly migrated lumbar disc hernia- tion [J].?Pain Physician, 2017, 20(1): E75-E84.
[6] Li ZZ, Ma SY, Cao Z, et al. Percutaneous isthmus foramino- plasty and full-endoscopic lumbar discectomy for very highly up-migrated lumbar disc herniation: technique notes and 2 years follow-up [J]. World Neurosurg, 2020, S1878- 8750(20): 30612-30614.
[7] Lee S, Kin SK, Lee SH, et al. Percutaneous endoscopic lum- bar discectomy for migrated disc herniation: classification of disc migration and surgical approaches [J]. Eur Spine J, 2007, 16(3): 431-437.
[8] 李柱海,曾建成,宋跃明,等. 经皮内镜椎间孔入路微创治 疗复发性腰椎间盘突出症疗效分析[J]. 中国修复重建外 科杂志,2015,29(1):43-47.
[9] Postacchini F,Postacchini R. Operative management of lum- bar discherniation: thr evolution of knowledge and surgical techniques in the last century [J]. Acta Neurochir Suppl, 2011, 108: 17-21.
[10] 王许可,周英杰,李无阴,等. 椎间孔镜靶向技术治疗中青 年腰椎间盘突出症[J]. 中国矫形外科杂志,2019,27(7): 592-596.
[11] 徐 彬,徐 峰,李 涛,等. 经皮椎间孔镜技术治疗脱出 游离型腰椎间盘突出症的临床研究 [J].中国矫形外科杂 志,2018,26(9):769-774.
[12] Ahn Y, Oh HK, Kim H, et al. Percutaneous endoscopic lum- bar foraminotomy: an advanced surgical technique and clinical outcomes [J] . Neurosurgery, 2014, 75(2): 124-133.

相似文献/References:

[1]舒 伟 李勇杰 陶 蔚 卢 光 张佳星 倪 兵 孙 涛 朱宏伟.经皮脊柱内镜下手术治疗腰5-骶1椎间盘突出症[J].中国临床神经外科杂志,2018,(01):4.[doi:10.13798/j.issn.1009-153X.2018.01.002]
 SHU Wei,LI Yong-jie,TAO Wei,et al.Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation[J].,2018,(09):4.[doi:10.13798/j.issn.1009-153X.2018.01.002]
[2]宋应豪 曾光亮 钱志远 孔祥宇 李如军.可撑开通道系统辅助下显微手术治疗腰椎间盘突出症[J].中国临床神经外科杂志,2018,(01):7.[doi:10.13798/j.issn.1009-153X.2018.01.003]
 SONG Ying-hao,ZENG Guang-liang,QIAN Zhi-yuan,et al.Treatment of lumbar disc herniation with microsurgery assisted by Caspar expandable channel system (report of 30 cases)[J].,2018,(09):7.[doi:10.13798/j.issn.1009-153X.2018.01.003]
[3]张志朋 汪冬生 刘合振.不同入路椎间孔镜术治疗腰椎间盘突出症的疗效及安全性比较[J].中国临床神经外科杂志,2018,(11):727.[doi:10.13798/j.issn.1009-153X.2017.11.007]
 ZHANG Zhi-peng,WANG Dong-sheng,LIU He-zhen.Curative effects intervertebral foraminoscopy via posteriolateral approach on lumbar disc herniation and its safeness compared with that via posterior approach[J].,2018,(09):727.[doi:10.13798/j.issn.1009-153X.2017.11.007]
[4]谭林英 徐 峰.经皮椎间孔镜术治疗腰椎间盘突出症合并后纵韧带骨化的疗效分析[J].中国临床神经外科杂志,2018,(12):788.[doi:10.13798/j.issn.1009-153X.2018.12.007]
 TAN Lin-ying,XU Feng.Treatment of lumbar disc herniation with ossification of posterior longitudinal ligament by percutaneous intervertebral foramen endosdcope surgery[J].,2018,(09):788.[doi:10.13798/j.issn.1009-153X.2018.12.007]
[5]王 璨 喻军华 袁学刚.骶管囊肿伴腰椎间盘突出症的手术治疗[J].中国临床神经外科杂志,2018,(12):804.[doi:10.13798/j.issn.1009-153X.2018.12.014]
[6]王海澎 杨希孟 朱宏伟 菅凤增 王大明 王作伟.经皮内镜椎间孔入路腰椎间盘切除术并发硬脊膜撕裂的综合处理及疗效分析[J].中国临床神经外科杂志,2020,(06):352.[doi:10.13798/j.issn.1009-153X.2020.06.005]
 WANG Hai-peng,YANG Xi-meng,ZHU Hong-wei,et al.Management and outcomes of dural tears during percutaneous endoscopic transforaminal lumbar discectomy for patients with lumbar disc herniation[J].,2020,(09):352.[doi:10.13798/j.issn.1009-153X.2020.06.005]
[7]徐 峰 伍搏宇 熊承杰 魏坦军 席金涛 赵东东 黄壁旺.靶向椎间孔成形技术与常规穿刺置管技术治疗腰椎间盘突出症的对比研究[J].中国临床神经外科杂志,2020,(08):503.[doi:10.13798/j.issn.1009-153X.2020.08.003]
 XU Feng,WU Bo-yu,XIONG Cheng-jie,et al.Comparison of targeted foraminoplasty and conventional puncture catheter technique during percutaneous transforaminal endoscopic discectomy for patients with lumbar disc herniations[J].,2020,(09):503.[doi:10.13798/j.issn.1009-153X.2020.08.003]
[8]翟亚业,秦晓彬,孟祥翔,等.腰椎间盘突出症经皮椎间孔镜术后类固醇激素的应用对比:硬膜外给药与静脉给药[J].中国临床神经外科杂志,2022,27(06):486.[doi:10.13798/j.issn.1009-153X.2022.06.018]
[9]宋博,王海羽,李国闯,等.导杆漂移技术穿刺置管在PTED治疗L5/S1椎间盘突出症中的应用[J].中国临床神经外科杂志,2022,27(11):905.[doi:10.13798/j.issn.1009-153X.2022.11.008]
 SONG Bo,WANG Hai-yu,LI Guo-chuang,et al.Application of working channel placement assissted by guide-rod drift technique to percutaneous transforminal endoscopic discectomy for patients with L5/S1 disc herniation[J].,2022,27(09):905.[doi:10.13798/j.issn.1009-153X.2022.11.008]
[10]何航,马俊,熊承杰,等.腰椎间盘突出症MSU分类与神经功能障碍的关系[J].中国临床神经外科杂志,2023,28(04):234.[doi:10.13798/j.issn.1009-153X.2023.04.003]
 HE Hang,MA Jun,XIONG Cheng-jie,et al.Relationship between Michigan State University (MSU) classification and neurological dysfunction of patients with lumbar disc herniation[J].,2023,28(09):234.[doi:10.13798/j.issn.1009-153X.2023.04.003]

备注/Memo

备注/Memo:
(2020-04-14收稿,2020-05-22修回)通讯作者:李绪贵,E-mail:spine672@163.com
更新日期/Last Update: 2020-09-20