经皮椎间孔镜联合经皮网袋成形技术治疗伴有神经根压迫症状的脊柱转移瘤

Percutaneous endoscopic combined with percutaneous mesh-container-plasty treatment of spinal metastases associated with nerve root compression

摘要:

评估经皮椎间孔镜联合经皮网袋成形技术（PMCP）治疗腰椎单节段伴有神经根压迫症状的脊柱转移瘤的临床疗效及安全性。方法 回顾性分析2012年9月－2016年12月应用经皮椎间孔镜联合PMCP治疗腰椎单节段伴有神经根压迫症状的脊柱转移瘤患者19例。观察手术时间、术中出血量和住院时间，采用视觉模拟评分（VAS）及MacNab标准评估手术疗效。按MacNab标准评定疗效优良率。结果 患者手术时间（105.52±14.25）min、术中出血量（35.58±6.76）ml、住院时间（8.25±2.14）d，术后第3天VAS评分（3.18±1.96）分、术后第3个月VAS评分与术前相比[（1.67±1.05）和（8.45±1.35）分]，差异均具有统计学意义（P <0.05）；按MacNab标准评定疗效优良率为84.21%。结论 经皮椎间孔镜联合PMCP具有手术时间短、术中出血少、创伤小及术后恢复快等诸多优点，是治疗腰椎单节段伴有神经根压迫症状的脊柱转移瘤安全、有效的微创手术。

Abstract:

To evaluate the clinical efficacy and safety of percutaneous endoscopic combined with percutaneous mesh-container-plasty in the treatment of spinal metastases with single segment of lumbar spine and nerve root compression. Methods Retrospective analysis of 19 patients with spinal metastases with lumbar vertebrae and nerve root compression with percutaneous endoscopic combined with percutaneous mesh-container-plasty from September 2012 to December 2016 was made. The operation time, intraoperative blood loss and hospitalization time were observed, and the curative effect was evaluated by visual analog scale (VAS) and MacNab criteria. According to MacNab standards to assess the excellent effect rate. Results The patient’s operation time (105.52 ± 14.25) min, intraoperative blood loss (35.58 ± 6.76) ml, hospitalization time (8.25 ± 2.14) d, the 3 d postoperative VAS score (3.18 ± 1.96) points, postoperative 3 months VAS score (1.67 ± 1.05) points, the postoperative VAS score was statistically significant compared with preoperative [(8.45 ± 1.35) points, (P < 0.05)]. According to the MacNab standard assessment of excellent efficacy rate of 84.21%. Conclusions Percutaneous endoscopic combined with percutaneous mesh-container-plasty has many advantages such as short operation time, less intraoperative blood loss, less trauma and quick recovery after surgery. It is a safe and effective minimally invasive surgery for the treatment of spinal metastases with single segment of the lumbar spine and nerve root compression.