摘要
目的探讨侧后方入路与椎板间隙入路经皮椎间孔镜技术(PTED)治疗中央型腰椎间盘突出症(CLDH)的疗效。方法152例CLDH患者按随机数字法分为观察组和对照组各76例。两组均行PTED术,观察组选择椎板间隙入路,对照组选择侧后方入路。比较两组手术指标和末次随访疗效差异,观察手术前后疼痛程度、腰椎功能等指标变化情况。结果观察组手术时间、住院时间均短于对照组,术中出血量、C臂透视次数均少于对照组(P<0.05);术后1月、3月、1年,两组患者VAS评分均较术前降低,且观察组低于对照组(P<0.05);术后1年,两组功能障碍指数问卷表(ODI)评分均较术前降低,JOA评分则较术前升高(P<0.05),组间比较差异无统计学意义(P>0.05);末次随访,两组术后优良率比较差异无统计学意义(P>0.05)。结论PTED是治疗CLDH的有效手术方案,侧后方入路与椎板间隙入路的手术治疗效果相当,但椎板间隙入路方式可缩短手术时间和住院时间,减少术中出血和透视次数,并能减轻术后疼痛。
Objective To explore the efficacy of lateral posterior approach and interlaminar approach for percutaneous transforaminal endoscopic discectomy(PTED)in the treatment of central lumbar disc herniation(CLDH).Methods One hundred and fifty-two CLDH patients were divided into observation or control group according to the computer random number method,76 in each group.The two groups underwent PTED,the observation group was given interlaminar approach,and the control group was given lateral posterior approach.The surgical indexes and the efficacy of last follow-up were compared between the two groups.The changes of pain degree and lumbar vertebral function were observed before and after operation.Results The operative time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss and C-arm fluoroscopy frequency were less than those in the control group(P<0.05).After 1 month,3 months and 1 year of operation,VAS score in the two groups was lower than that before operation,and the score in the observation group was lower than that in the control group(P<0.05).After 1 year of operation,ODI score in the two groups was lower than that before operation while the JOA score was higher than that before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).At the last follow-up,no significant difference in excellent and good rate after operation was found between the two groups(P>0.05).Conclusion PTED is an effective surgical procedure for CLDH,and the lateral posterior approach and interlaminar approach are equivalent in the surgical treatment effect.However,interlaminar approach can shorten the operative time and hospital stay,reduce the intraoperative blood loss and fluoroscopy frequency,and relieve the postoperative pain.
作者
管树军
GUAN Shu-jun(Department of Orthopaedics,Jinzhou Central Hospital,Jinzhou 121000,China)
出处
《实用医院临床杂志》
2020年第2期126-129,共4页
Practical Journal of Clinical Medicine
