1007-1989（2016）01-0032-05

Evaluation on percutaneus transforaminal endoscopic discectomy in treatment for 60 cases of the single segment of the lumbar disc herniation

摘要:

目的  探讨经皮椎间孔镜治疗单节段腰椎间盘突出症的临床疗效。方法  选择2013年2月－2014年1月收治的60例采用经皮椎间孔镜治疗的单节段腰椎间盘突出症患者，根据术前、术后1 d、术后3及6个月患者疼痛视觉模拟评分（VAS）及改良的MacNab标准评价临床疗效。结果  60例患者手术均顺利完成，手术时间平均（65.00±12.00）min，无硬膜囊破裂、神经根及血管损伤、感染等并发症。术后1例患者症状改善不明显，改行开放性手术后缓解。余病例腰腿痛症状较前均明显缓解，并获6～12个月随访，术后2个月行腰椎磁共振成像（MRI）检查证实突出髓核组织均切除彻底，神经根及硬膜囊受压解除。术后6个月随访，腰痛VAS评分术前术后差值的均数及标准差为（4.42±1.45）分，腿痛VAS评分术前术后差值的均数及标准差为（6.49±1.67）分，差异均具有统计学意义（P <0.05）。根据改良的MacNab标准，优31例；良20例；可7例；差1例，优良率86.4%。结论  经皮椎间孔治疗单节段腰椎间盘突出症具有手术时间短、创伤小和临床效果确切等优点。

Abstract:

Abstract: Objective To disscuss the clinical curative effect of percutaneous transforaminal endoscopic discectomy for the single segment of the lumbar disc herniation. Methods Sixty patients of the single segment of the lumbar disc herniation were treated by percutaneous transforaminal endoscopic discectomy from February 2013 to January 2014. The visual analogue scale (VAS) of preoperative, after one day, three months and six months, and modified MacNab criteria were employed to measure the clinical outcome. Results Surgery of 60 cases were successfully completed, the average operation time was (65.00 ± 12.00) min, no complications occurred such as dural sac ruptured, nerve root and vascular injury, infection, and so on one patient's symptoms can't be improved obviously after the operation, the patient's symptoms was relieved by open surgery. The remaining cases' lumbocrural pain symptoms were improved obviously. All patients were followed up for 6 to 12 months, 2 months after the operation, the lumbar MRI confirmed that the prominent nucleus pulposus tissue were removed completely, Compression of the nerve roots and dural sac was relieved. Follow up 6 months after operation, the VAS score of low back pain for the difference of the mean and standard deviation of the preoperative and postoperative were (4.42 ± 1.45) scores, and the VAS score of leg pain for he difference of the mean and standard deviation of the preoperative and postoperative were (6.49 ± 1.67) scores, the differences were statistically significant. By modified MacNab criteria, the excellent is 31 cases, the good is 20 cases, the medium is 7 cases, and the poor is 1 cases, the rate of excellent and good is 86.4%. Conclusions The percutaneous transforaminal endoscopic discectomy is used to cure the single segment of the lumbar disc herniation with the advantages of Shorter operation time, smaller trauma, obvious clinical effect, and so on.