随着我国社会经济水平的发展以及人口结构趋向老龄化,中老年人腰椎退行性病患者也日益增多,腰椎退行性疾病的发病率逐年上升,给患者的生活质量带来了显著影响。传统的开放手术治疗方法虽然有效,但往往伴随较大的创伤和恢复期,限制了其...随着我国社会经济水平的发展以及人口结构趋向老龄化,中老年人腰椎退行性病患者也日益增多,腰椎退行性疾病的发病率逐年上升,给患者的生活质量带来了显著影响。传统的开放手术治疗方法虽然有效,但往往伴随较大的创伤和恢复期,限制了其在广泛人群中的应用,并且绝大多数患者更倾向于通过微创技术解决问题。近年来经皮椎间孔镜技术(Percutaneous Endoscopic Discectomy, PELD)已成为治疗腰椎退行性疾病的有效手术方法之一,作为一种微创外科手术手段,以其创伤小、恢复快和疼痛少等优点,在腰椎退行性疾病的治疗中得到了广泛关注。尽管该技术在临床应用中展现出良好的前景,但仍存在适应症选择、手术技术熟练度、临床效果及并发症管理等方面的问题。本文旨在综述经皮椎间孔镜技术在腰椎退行性疾病中的最新研究进展,深入分析其适应症、手术技术、临床效果及并发症管理等关键内容,以期为今后的临床应用提供参考和指导。With the development of our country’s social and economic level and the aging population structure, the number of middle-aged and elderly patients with lumbar degenerative diseases is also increasing. The incidence of lumbar degenerative diseases is rising year by year, significantly affecting the quality of life of patients. Although traditional open surgical treatment methods are effective, they often come with considerable trauma and recovery time, limiting their application in a wide population, and most patients prefer to solve problems through minimally invasive techniques. In recent years, percutaneous endoscopic discectomy (PELD) has become one of the effective surgical methods for treating lumbar degenerative diseases. As a minimally invasive surgical approach, it has gained widespread attention in the treatment of lumbar degenerative diseases due to its advantages of minimal trauma, quick recovery, and less pain. Despite the promising prospects of this technology in clinical applications, there are still issues regarding the selection of indications, surgical skill proficiency, clinical outcomes, and management of complications. This article aims to review the latest research progress of percutaneous endoscopic discectomy technology in lumbar degenerative diseases, analyzing key aspects such as indications, surgical techniques, clinical outcomes, and management of complications, in order to provide reference and guidance for future clinical applications.展开更多
目的探讨体质量指数(body mass index,BMI)对后路360°融合术治疗单节段腰椎退行性疾病疗效的影响。方法回顾分析2009年9月-2013年9月收治的符合选择标准的302例行后路360°融合术治疗的单节段腰椎退行性疾病患者临床资料。根...目的探讨体质量指数(body mass index,BMI)对后路360°融合术治疗单节段腰椎退行性疾病疗效的影响。方法回顾分析2009年9月-2013年9月收治的符合选择标准的302例行后路360°融合术治疗的单节段腰椎退行性疾病患者临床资料。根据术前BMI不同将患者分为3组,A组为正常体重组(BMI<24kg/m^2),105例;B组为超重组(24 kg/m^2≤BMI<28 kg/m^2),108例;C组为肥胖组(BMI≥28 kg/m^2),89例。3组患者性别、年龄、病程、病变类型、病变节段及术前日本骨科协会(JOA)评分与Oswestry功能障碍指数(ODI)比较差异均无统计学意义(P>0.05),具有可比性。记录患者手术时间、术中出血量、术后住院时间、术后并发症情况;术前及术后3、6、24个月采用腰椎JOA评分及ODI评价患者腰椎功能情况。结果 C组手术时间、术中出血量及术后住院时间均显著多于A、B组(P<0.05);A、B组间比较差异无统计学意义(P>0.05)。3组患者均获2年以上随访,随访时间24~45个月。各组术后各时间点JOA评分及ODI均较术前显著改善(P<0.05);术后各时间点3组间比较,差异均无统计学意义(P>0.05)。并发症发生情况:3组患者术后总体并发症发生率比较差异无统计学意义(χ~2=3.288,P=0.193)。其中C组切口相关并发症(切口感染和切口愈合不良)发生率显著高于A、B组(P<0.05),A、B组间差异无统计学意义(P>0.05);脑脊液漏、假关节形成及翻修等并发症发生率3组间比较差异均无统计学意义(P>0.05)。结论不同BMI的腰椎退行性疾病患者行后路360°融合术均能获得良好临床疗效,但BMI≥28 kg/m^2患者手术时间更长、术中出血更多、术后住院时间更长,且术后切口相关并发症发生率更高。展开更多
文摘随着我国社会经济水平的发展以及人口结构趋向老龄化,中老年人腰椎退行性病患者也日益增多,腰椎退行性疾病的发病率逐年上升,给患者的生活质量带来了显著影响。传统的开放手术治疗方法虽然有效,但往往伴随较大的创伤和恢复期,限制了其在广泛人群中的应用,并且绝大多数患者更倾向于通过微创技术解决问题。近年来经皮椎间孔镜技术(Percutaneous Endoscopic Discectomy, PELD)已成为治疗腰椎退行性疾病的有效手术方法之一,作为一种微创外科手术手段,以其创伤小、恢复快和疼痛少等优点,在腰椎退行性疾病的治疗中得到了广泛关注。尽管该技术在临床应用中展现出良好的前景,但仍存在适应症选择、手术技术熟练度、临床效果及并发症管理等方面的问题。本文旨在综述经皮椎间孔镜技术在腰椎退行性疾病中的最新研究进展,深入分析其适应症、手术技术、临床效果及并发症管理等关键内容,以期为今后的临床应用提供参考和指导。With the development of our country’s social and economic level and the aging population structure, the number of middle-aged and elderly patients with lumbar degenerative diseases is also increasing. The incidence of lumbar degenerative diseases is rising year by year, significantly affecting the quality of life of patients. Although traditional open surgical treatment methods are effective, they often come with considerable trauma and recovery time, limiting their application in a wide population, and most patients prefer to solve problems through minimally invasive techniques. In recent years, percutaneous endoscopic discectomy (PELD) has become one of the effective surgical methods for treating lumbar degenerative diseases. As a minimally invasive surgical approach, it has gained widespread attention in the treatment of lumbar degenerative diseases due to its advantages of minimal trauma, quick recovery, and less pain. Despite the promising prospects of this technology in clinical applications, there are still issues regarding the selection of indications, surgical skill proficiency, clinical outcomes, and management of complications. This article aims to review the latest research progress of percutaneous endoscopic discectomy technology in lumbar degenerative diseases, analyzing key aspects such as indications, surgical techniques, clinical outcomes, and management of complications, in order to provide reference and guidance for future clinical applications.
