经皮椎间孔镜技术治疗钙化型腰椎间盘突出症手术技巧及疗效分析
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1.浙江新安国际医院;2.河南省直第三人民医院

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Surgical skills and curative effect analysis of percutaneous transforaminal endoscopic discectomy in the treatment of calcified lumbar disc herniation
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1.Zhejiang sin an International Hospital;2.The Third People&3.amp;4.#39;5.&6.s Hospital of Henan Province

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    [目的] 浅析经皮椎间孔镜技术(percutaneous transforaminal endoscopic discectomy,PTED)治疗钙化型腰椎间盘突出症手术技巧及疗效。[方法] 选取我院自2017年01月至2020年10月确诊为钙化型腰椎间盘突出症并收治患者17例。按术前CT影像学表现,对责任节段钙化的间盘形态进行分型(孤立型、半月型和连续型),并根据其分型采取相应的手术操作技术。比较分析17例患者术前与术后3天、6个月、12个月、24个月腰腿痛的疼痛视觉模拟评分(visual analogue scale, VAS)和Oswestry功能障碍指数(the Oswestry disability index,ODI)的差异。末次随访时,采用改良MacNab标准评定术后疗效的优良率。[结果] 所有患者均顺利完成PTED手术,均无并发症发生。术后VAS评分、Oswestry功能障碍指数与术前相比均明显降低,差异有统计学意义(P<0.05)。末次随访按照改良 MacNab 标准评定术后疗效,优11例,良4例,中1例,差1例,优良率为88%(15/17)。[结论] 依据钙化的椎间盘不同分型,采取相应的手术操作技巧治疗钙化型腰椎间盘突出症是一种安全有效的微创手术方案。值得推广。

    Abstract:

    Abstract:[Objective] To analyze the surgical techniques and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of calcified lumbar disc herniation. [Methods] We selected 17 patients who were diagnosed with calcified lumbar disc herniation from January 2017 to October 2020 in our hospital. According to the preoperative CT imaging findings, the calcified disc morphology of the responsible segment was classified (isolated, semilunar and continuous), and corresponding surgical techniques were adopted according to the classification. Comparison and analysis of 17 patients preoperative and 3 days, 6 months, 12 months, 24 months postoperative low back pain visual analog score(VAS) and Oswestry differences(ODI). At the last follow-up, the improved MacNab standard was used to evaluate the excellent and good rate of postoperative efficacy. [Results] All patients successfully completed PTED surgery without complications. The postoperative VAS score and Oswestry dysfunction index were significantly lower than those preoperative, and the difference was statistically significant (P<0.05). At the last follow-up, the postoperative efficacy was evaluated according to the modified MacNab standard. 11 cases were excellent, 4 cases were good, 1 case was fair, and 1 case was poor. The excellent and good rate was 88% (15/17). [Conclusion] According to the different types of calcified intervertebral discs, it is a safe and effective minimally invasive surgery to adopt corresponding surgical techniques to treat calcified lumbar disc herniation. Worth promoting.

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  • 收稿日期:2021-02-10
  • 最后修改日期:2021-04-12
  • 录用日期:2021-05-18
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