[1]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):503-505.[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,(08):503-505.[doi:10.13798/j.issn.1009-153X.2020.08.003]
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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()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年08期
页码:
503-505
栏目:
论著
出版日期:
2020-08-25

文章信息/Info

Title:
Comparison of targeted foraminoplasty and conventional puncture catheter technique during percutaneous transforaminal endoscopic discectomy for patients with lumbar disc herniations
文章编号:
1009-153X(2020)08-0503-03
作者:
徐 峰 伍搏宇 熊承杰 魏坦军 席金涛 赵东东 黄壁旺
430070 武汉,中国人民解放军中部战区总医院骨科(徐 峰、伍搏宇、熊承杰、魏坦军、席金涛、赵东东、黄壁旺)
Author(s):
XU Feng WU Bo-yu XIONG Cheng-jie WEI Tan-jun XI Jin-tao ZHAO Dong-dong HUANG Bi-wang.
Orthopedic Department, General Hospital, Central Theater Command, PLA, Wuhan 430070, China
关键词:
腰椎间盘突出症靶向椎间孔成形技术常规穿刺置管技术经皮椎间孔镜下椎间盘切除术
Keywords:
Lumbar disc herniation Targeted foraminoplasty Percutaneous transforaminal endoscopic discectomy
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2020.08.003
文献标志码:
R 681.5+7
摘要:
目的 比较经皮内镜靶向椎间孔成形技术与常规穿刺置管技术进行经皮椎间孔镜下椎间盘切除术(PTED)治疗腰椎间盘突出症(LDH)的临床疗效。方法 回顾性分析2017年9月至2018年12月行PTED治疗的91例单节段LDH的临床资料,其中43例采用靶向椎间孔成形技术穿刺置管(靶向成形组),48例采用常规穿刺置管(常规组)。术前、术后1 d、1个月、3个月、末次随访时,采用视觉模拟量表(VAS)评分及Oswestr功能障碍指数(ODI)评估腰腿痛改善情况及功能恢复情况。末次随访时,采用改良Macnab评分标准评定优良率。结果 与常规组相比,靶向成形组透视次数明显减少、通道建立时间和手术时间明显缩短(P<0.05)。两组术后VAS评分、ODI较术前均明显改善(P<0.05),但两组之间无统计学差异(P>0.05)。末次随访改良MacNab评分:靶向成形组优 28 例,良12例,可2例,差1例,优良率为93.02%;常规组优27例,良17例,可4例,优良率为 91.67%。两组优良率无统计学差异(P>0.05)。结论 靶向椎间孔成形技术可有效降低PTED的学习曲线,减少术中透视次数及手术时间
Abstract:
Objective To compare the clinical efficacy of percutaneous endoscopic targeted foraminoplasty and conventional puncture catheterization technique during the percutaneous foraminal discectomy (PTED) in the treatment of patients with lumbar disc herniation (LDH). Methods The clinical data of 91 patients with single-segment LDH who were treated with PTED from September 2017 to December 2018 were retrospectively analyzed. Of these 91 patients, 43 patients used the targeted foraminoplasty technique to puncture the catheter (targeted group), and 48 used routine puncture catheterization (control group). Before the operation, 1 day, 1 month, and 3 months after the operation, and at the last follow-up, the visual analog scale (VAS) score and Oswestr dysfunction index (ODI) were used to evaluate the improvement of low back pain and functional recovery. At the last follow-up, the modified Macnab scoring standard was used to assess the spnial function. Results Compared with the control group, the number of fluoroscopy was significantly reduced, and the passage time and operation time were significantly shortened in the targeted group (P<0.05). The postoperative VAS score and ODI were significantly improved after the surgery in the both groups (P<0.05), but there was no statistical difference between the two groups (P>0.05). There was no statistical difference in the excellent and good rate according to the modified MacNab score between targeted group (93.02%) and control group (91.67%; P>0.05). Conclusion Targeted foraminoplasty technique can effectively reduce the learning curve of PTED, and reduce the number of intraoperative fluoroscopy and operation time

参考文献/References:

[1] 金丹杰,徐南伟,赵国辉,等. 经皮椎间孔镜与椎板开窗椎 间盘切除术治疗腰椎间盘突出症的前瞻性随机对照研 究[J]. 中国微创外科杂志,2017,17(6):491-494.
[2] 周 跃,李长青,王 建,等. 椎间孔镜 YESS 与 TESSYS 技术治疗腰椎间盘突出症[J].中华骨科杂志,2010,30 (3):225-231.
[3] 吴继彬,葛保健,吴东迎,等. 椎板开窗与椎间孔镜治疗腰 椎间盘突出症比较[J]. 中国矫形外科杂志,2016,24 (21):1972-1976.
[4] Ruan W, Feng F, Liu Z, et al. Comparison of percutaneous endoscopic lumbar discectomy versus open lumbar micro- discectomy for lumbar disc herniation: a meta-analysis [J]. Int J Surg, 2016, 31: 86-92.
[5] 王 翀,田 征,梁青福,等. 经皮椎间孔镜TESSYS技术 治疗单节段腰椎间盘突出症60例分析[J]. 中国内镜杂 志,2016,22(1):32-36.
[6] Ozer AF, Suzer T, Can H, et al. Anatomic assessment of variations in Kambin's triangle: a surgical and cadaver study [J]. World Neurosurg, 2017, 100: 498-503.
[7] Ao S, Wu J, Zheng W, et al. A novel targeted foraminoplasty device improves the efficacy and safety of foraminoplasty in percutaneous endoscopic lumbar discectomy: preliminary clinical application of 70 cases [J]. World Neurosurg, 2018, 115: e263-e271.
[8] Sairyo K, Matsuura T, Higashino K, et al. Surgery related complications in percutaneous endoscopic lumbar discec- tomy under local anesthesia [J]. J Med Invest, 2014, 61(3- 4): 264-269.
[9] 张良民,刘明永,范伟力,等. 侧后路椎间孔镜手术相关并 发症及预防措施[J]. 局解手术学杂志,2017,26(10): 746-749.
[10] Cho JY, Lee SH, Lee HY. Prevention of development of postoperative dysesthesia in transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation: floating retraction technique [J]. Minim Invasive Neurosurg, 2011, 54(5-6): 214-218.
[11] Guan X, Gu X, Zhang L, et al. Morphometric analysis of the working zone for posterolateral endoscopic lumbar discec- tomy based on magnetic resonance neurography [J]. J Spinal Disord Tech, 2015, 28(2): E78-E84.

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备注/Memo

备注/Memo:
(2019-07-12收稿,2020-05-31修回)基金项目:全军医学科技青年培育计划(18QNP054)
更新日期/Last Update: 2020-08-12