经皮内镜下椎板间入路椎间盘切除术对腰椎间盘突出症患者疼痛和腰椎功能的影响

Impacts of percutaneous endoscopic interlaminar discectomy on pain and lumbar function in patients with lumbar disc herniation

摘要:

目的 探讨经皮内镜下椎板间入路椎间盘切除术（PEID）对腰椎间盘突出症（LDH）患者疼痛程度和腰椎功能的影响。方法 选取2022年1月－2023年8月该院收治的L_4/5节段LDH患者84例，根据治疗方法不同，将患者分为试验组（42例）和传统组（42例）。传统组行传统开放入路治疗，试验组采用PEID治疗。比较两组患者手术指标（住院时间、手术时间、卧床时间和术中透视次数）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平；采用视觉模拟评分法（VAS）评分和Oswestry功能障碍指数（ODI），评估患者腰部和下肢的疼痛程度和腰椎功能；比较两组患者临床满意度的优良率和并发症发生率。结果 试验组住院时间和卧床时间明显短于传统组，透视次数明显多于传统组，手术时间明显长于传统组，差异均有统计学意义（P < 0.05）；治疗后，两组患者腰部和下肢疼痛VAS评分、ODI、IL-6和TNF-α明显低于治疗前，且试验组明显低于传统组，差异均有统计学意义（P < 0.05）；试验组和传统组优良率分别为88.10%和83.33%，差异无统计学意义（P > 0.05）；两组患者并发症总发生率比较，差异无统计学意义（P > 0.05）。结论 采用PEID治疗LDH，能有效地缓解神经压迫，减轻患者腰部和下肢的疼痛，促进腰椎功能恢复，利于患者术后康复。

Abstract:

Objective To investigate the impacts of percutaneous endoscopic interlaminar discectomy (PEID) on pain level and lumbar function in patients with lumbar disc herniation (LDH).Methods From January 2022 to August 2023, 84 patients were diagnosed with L_4/5 LDH based on clinical data and imaging information were selected as the study subjects. And they were assigned into 42 cases in experimental group and 42 cases in traditional groups complying with treatment methods. The traditional group underwent traditional open approach treatment, while the experimental group underwent PEID. The surgical indicators (including hospitalization time, surgical time, bed rest time, and intraoperative fluoroscopy frequency), the levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were compared between the two groups, the visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to quantify the pain level of waist and lower limbs and lumbar function, and the excellent and good rate of clinical satisfaction and the incidence of complications were compared.Results The hospitalization time and bed rest time of the experimental group were obviously shorter than those of the traditional group, while the fluoroscopy frequency was less than that of the traditional group, and surgical time was longer than that of the traditional group, the differences were statistically significant (P < 0.05). After treatment, the pain VAS score and ODI of waist and lower limbs, the IL-6, and TNF-α in the two groups were lower than those before treatment, the experimental group was lower than the traditional group, the differences were statistically significant (P < 0.05). The excellent and good rate of the experimental group and the traditional group were 88.10% and 83.33%, respectively, with no statistically significant difference (P > 0.05). There was no statistically significant difference in the total incidence of complications between the two groups （P > 0.05）.Conclusion PEID surgery can effectively alleviate nerve compression, alleviate pain of waist and lower limbs, promote the recovering of lumbar function, and facilitate postoperative recovery in LDH patients.