全可视内镜下髓核摘除联合纤维环修复治疗腰椎间盘突出症
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文登整骨医院

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第七批全国老中医药专家传承项目


Clinical effectiveness of annulus repair affter discectomy under fully visible endoscopic treatment of lumbar disc herniation
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The Wendeng Osteopath Hospital

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    摘要:

    摘 要 目的:探讨采用全可视内镜下髓核摘除联合纤维环修复治疗腰椎间盘突出症(LDH)的临床疗效。方法:纳入2019年1月-2021年1月收治LDH患者82例,其中采用单纯全可视内镜下髓核摘除手术治疗47例(对照组),采用全内镜下髓核摘除联合纤维环修复治疗35例(修复组),记录手术时间及术中出血量,记录术前、术后10d及术后3、6、12、18个月Oswestry功能障碍指数(ODI)、腰痛和下肢痛的目测类比(VAS)评分,观察2组手术并发症及术后复发情况。结果:2组手术均顺利完成,且获得完整随访,修复组手术时间高于对照组(P<0.05),2组术中出血量差异无统计学意义(P>0.05),2组间术后各时间点复查腰腿痛(VAS)评分和ODI指数差异无统计学意义(P>0.05),2组术后各时间点复查腰腿痛(VAS)评分和ODI指数较术前明显改善,差异有统计学意义(P<0.05),2组均未发生硬膜囊撕裂、术后感染、椎管内血肿压迫等严重并发症,对照组复发率8.51%,其中30.4%再次手术,修复组无复发及再手术者。结论:采用全可视内镜下髓核摘除联合纤维环修复治疗腰椎间盘突出症可获得显著的早期临床效果,可有效降低术后复发和再次手术的风险。

    Abstract:

    ABSTRACT Objective:Exploring the clinical efficacy of using full visual endoscopic nucleus pulposus removal combined with fiber ring repair for the treatment of lumbar disc herniation (LDH)..Methods:82 patients with LDH were enrolled from January 2019 to January 2021. Among them, 47 patients were treated with simple full visual endoscopic nucleus pulposus removal surgery (control group), and 35 patients were treated with total endoscopic nucleus pulposus removal combined with fiber ring repair (repair group). The surgical time and intraoperative bleeding were recorded, and Oswestry Dysfunction Index (ODI), visual analogue (VAS) scores of low back pain and lower limb pain were recorded before, 10 days after surgery, and 3, 6, 12, and 18 months after surgery, Observe the surgical complications and postoperative recurrence in two groups.Results:Both groups of surgeries were successfully completed and received complete follow-up. The repair group had a longer surgical time than the control group (P<0.05), and there was no statistically significant difference in intraoperative bleeding between the two groups (P>0.05). There was no statistically significant difference in the VAS score and ODI index at each postoperative time point between the two groups (P>0.05). The VAS score and ODI index at each postoperative time point in the two groups were significantly improved compared to before surgery, and the difference was statistically significant (P<0.05), Both groups did not experience serious complications such as dural sac tear, postoperative infection, and compression of spinal hematoma. The recurrence rate in the control group was 8.51%, of which 30.4% underwent surgery again. There were no recurrence or reoperation cases in the repair group.Conclusion:The use of full visual endoscopic nucleus pulposus removal combined with fiber ring repair for the treatment of lumbar disc herniation can achieve significant early clinical results, effectively reducing the risk of postoperative recurrence and reoperation.

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  • 收稿日期:2023-05-12
  • 最后修改日期:2023-05-12
  • 录用日期:2023-07-18
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