经皮椎间孔镜治疗老年腰椎间盘突出症临床疗效分析

doi:10.13418/j.issn.1001-165x.2015.04.025

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (4): 482-484.doi: 10.13418/j.issn.1001-165x.2015.04.025

经皮椎间孔镜治疗老年腰椎间盘突出症临床疗效分析

肖隆艺¹，　禤天航^1,2 ，　曹正霖¹

1.广州中医药大学附属佛山市中医院骨科，广东佛山 528000； 2.广州中医药大学，广州 510405

收稿日期:2015-04-29 出版日期:2015-07-25 发布日期:2015-08-14
作者简介:肖隆艺（1976-），男，江西人，硕士，副主任医师，主要研究方向：脊柱外科学，Tel：(0757)83061101， E-mail：foshanxly@163.com

Clinical effects of percutaneous transforaminal endoscopic discectomy for the treatment of senile lumbar disc herniation

XIAO Long-yi¹，XUAN Tian-hang ^1,2，CAO Zheng-lin ¹

1.Department of Orthopaedics，Foshan Hospital of TCM， Foshan, Guangdong 528000，China；2.Guangzhou University of Chinese Medicine， Guangzhou 510405，China

Received:2015-04-29 Online:2015-07-25 Published:2015-08-14

摘要/Abstract

摘要：

目的　观察经皮椎间孔镜治疗保守治疗无效的老年腰椎间盘突出症患者的近期疗效。方法　通过TESSYS椎间孔镜技术治疗24例老年性单节段腰椎间盘突出症，并使用VAS评分、ODI指数、及改良Macnab标准评价术后疗效。结果　术后末次随访VAS评分为(1.83±0.48)，明显低于术前（7.67±0.82）。术后末次随访ODI指数为（14.42±2.04）% ，明显低于术前（69.83±2.82）%。改良Macnab疗效评价为：优 20 例，良 3 例，可 1 例。术后患者腿痛症状均得到有效缓解。结论　经皮椎间孔镜治疗老年人腰椎间盘突出症近期疗效良好，远期效果还需进一步观察。

关键词: 椎间孔镜, 髓核摘除术, 射频消融, 腰椎间盘突出症

Abstract:

Objective　To analyze the effects of Percutaneous Endoscopic Lumbar Discectomy (PELD) in treatment of the senile lumbar disc herniation after conservative treatment.　Methods　24 elderly in-paients with single lumbar disc herniation received PELD . The outcomes were evaluated with the visual analogue scale(VAS)，Oswestry disability index (ODI) and modified Macnab criteria before and after the operation.　Results　On the last follow-up after operation, VAS scores (1.83±0.48) were significantly lower than preoperative score（7.67±0.82）. The postoperative last follow-up ODI（14.42±2.04）% were also significantly lower than preoperative one（69.83±2.82）%. Based on the modified Macnab criteria，the outcome was excellent in 20 cases，good in 3 and fair in 1. The leg pain symptoms were effectively relieved in all cases after operation.　Conclusions　PELD shows significant immediate effect in treating senile lumbar disc herniation and the long-term effects still need further observation.

Key words: Transforaminal endoscope, Discectomy, Radiofrequency, Lumbar intervertebral disc herniation

肖隆艺,禤天航,曹正霖. 经皮椎间孔镜治疗老年腰椎间盘突出症临床疗效分析[J]. 中国临床解剖学杂志, 2015, 33(4): 482-484.

参考文献

[1] Crock HV. Normal and pathological anatomy of the lumbar spinal nerve root canals[J].J Bone Joint Surg Br，1981，63B (4): 487-490.
[2] 袁仕国，李义凯，王华军，等.腰椎间孔侵入性操作的应用解剖[J].中国临床解剖学杂志，2010,28(2)：127-130.
[3] 张烽，段广超，王素春，等.下腰椎侧方血管神经及毗邻结构的应用解剖[J].中国临床解剖学杂志,2007，25(2):152-155.
[4] Ciric I. The lateral recess syndrome[J]. J Neurosurg, 1980,53:433-443.
[5] Kirkaldy-Willis WH, Wedge JH, Young-Hing K, et al.Pathology and pathogenesis of lumbar spondylosis and stenosis[J]. Spine, 1978,3(4):319-327.
[6] 李振宙，候树勋，吴闻文，等. 经皮侧后路腰椎间孔成形术对腰椎解剖及生物力学影响的实验研究[J].中国骨肿瘤骨病,2010,9(6)：503-508
[7] Lee CK. Lumbar spinal instability (olisthesis) after extensive posterior spinal decompression[J]. Spine, 1983,8(4):429-433
[8] Masevnin S,Ptashnikov D,Michaylov D,et al．Risk factors for adjacent segment disease development after lumbar fusion[J]．Asian Spine J， 2015，9(2):239-244.
[9] Ekman P, Möller H, Shalabi A,et al. A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration[J]. Eur Spine J，2009 ,18(8):1175-1186
[10]Etebar S．Cahill DW．Risk factors for adjacent segment failure following lumbar fixation with rigid instrumentation for degenerative instability[J]．J Neurosurg，1999，90（2 Suppl）：163-169.
[11]Katz JN, Lipson SJ,Chang LC, et al. Seven to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis [J]. Spine,1996,21(1):92-94.
[12]Hoogland T, Schubert M, Miklitz B, et al. Transforaminal posterolateral endoscopic discectomy with or without the combination of alow-dose chymopapain:a prospective randomized study in 280 consecutive cases[J]. Spine,2006,31(24):E890-897.
[13]何俊,赵正旭,林杭,等. 椎间孔镜经后外侧椎间孔入路治疗老年腰椎间盘突出症伴侧隐窝狭窄[J].浙江医学，2013，35（11）：1052-1053
[14] Ruetten S, Komp M, Merk H, Godolias G.Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique:a prospective, randomized, controlled study[J].Spine,2008,33(9):931-939
[15]Ahn Y. Percutaneous endoscopic decompression for lumbar spinal stenosis[J]. Expert Rev Med Devices,2014，11(6):605-616.
[16]张德辉，张智慧，黄涛. 椎间孔镜下摘除腰椎椎间盘巨大脱出失败1例[J].脊柱外杂志，2013,11(4):255-256.

经皮椎间孔镜治疗老年腰椎间盘突出症临床疗效分析

Clinical effects of percutaneous transforaminal endoscopic discectomy for the treatment of senile lumbar disc herniation

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