摘要
目的分析经皮椎间孔镜手术治疗腰椎间盘突出症出现疗效欠佳及并发症的原因,探讨其预防与应对方式。方法回顾性分析2017年2月—2019年6月行椎间孔镜手术-TESSYS技术治疗腰椎间盘突出症的患者182例,记录术中、术后并发症发生情况,随访8~48个月,以末次随访的改良MacNab评分进行疗效评价。结果182例手术中转开放手术0例、术后椎间隙感染0例、术中出现头颈部疼痛的18例、硬脊膜撕裂5例、神经损伤1例、术后复发6例;有效随访167例,优良率为90.4%(151/167),技术开展早期的50例的患者优良率为82.0%(41/50),技术开展后50例患者的优良率为94.0%(47/50);患者年龄>60岁的优良率为83.6%(41/49),≤60岁的优良率为93.2%(110/118)。结论新技术学习期、患者年龄、手术适应证选择是影响椎间孔镜术后疗效的原因,术中规范的操作、维持清晰的视野、熟练掌握工具的使用是预防并发症发生的基础。
Objective To analyze the causes of poor efficacy and complications in the treatment of lumbar intervertebral disc herniation by percutaneous intervertebral foraminal surgery,and explore its prevention and coping methods.Methods A retrospective analysis of 182 patients who underwent intervertebral foraminal surgery-TESSYS technology for treatment of lumbar disc herniation from February 2017 to June 2019,recorded the occurrence of intraoperative and postoperative complications,and followed up for 8 to 48 months,to evaluate the efficacy of the modified MacNab score at the last follow-up.Results 0 cases of 182 cases converted to open surgery,0 cases of postoperative intervertebral space infection,18 cases of head and neck pain during operation,5 cases of spinal dural tear,1 case of nerve injury,and 6 cases of postoperative recurrence;effective follow-up of 167 cases,the excellent and good rate was 90.4%(151/167),the excellent and good rate of 50 patients in the early stage of technical development was 82.0%(41/50),and the excellent and good rate of 50 patients was 94.0%after the technology was carried out(47/50);The excellent and good rate of patients>60 years old was 83.6%(41/49),and the excellent and good rate of patients≤60 years old was 93.2%(110/118).Conclusion The learning period of new technology,the age of the patient,and the choice of surgical indications are the reasons that affect the efficacy of foraminal endoscopy,and standardized operation,maintenance of clear vision,and proficient use of tools are the basis for preventing complications.
作者
刘路星
陈良龙
郑阳
杨静海
刘继成
李昭
LIU Luxing;CHEN Lianglong;ZHENG Yang;YANG Jinghai;LIU Jicheng;LI Zhao(th Ward of Spine Surgery,Loudi Central Hospital,Loudi,Hunan province,417000 China)
出处
《中外医疗》
2021年第10期26-29,共4页
China & Foreign Medical Treatment
基金
湖南省科技厅创新引导项目(2017SK51204)。
关键词
椎间盘突出症
椎间孔镜
疗效欠佳
并发症
Intervertebral disc herniation
Intervertebral foramoscope
Poor curative effect
Complications
