[1]徐王兵,李 勇△,钟发明,等.两种脊柱微创手术治疗老年L5/S1椎间盘突出症疗效比较及对患者VAS及JOA评分的影响*[J].陕西医学杂志,2020,49(1):72-75.
　XU Wangbing,LI Yong,ZHONG Faming,et al.Curative effect of two spinal minimally invasive surgeries in the treatment of elderly patients with L5/S1 lumbar discherniation and the influence on VAS and JOA scores[J].,2020,49(1):72-75.
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两种脊柱微创手术治疗老年L5/S1椎间盘突出症疗效比较及对患者VAS及JOA评分的影响*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年1期
页码:
72-75
栏目:
临床研究
出版日期:
2020-01-05

文章信息/Info

Title:
Curative effect of two spinal minimally invasive surgeries in the treatment of elderly patients with L5/S1 lumbar discherniation and the influence on VAS and JOA scores
文章编号:
DOI:10.3969/j.issn.10007377.2020.01.019
作者:
徐王兵; 李 勇△; 钟发明; 叶勇祥; 翁佳琦
江西中医药大学附属医院(南昌 330006)
Author(s):
XU Wangbing; LI Yong; ZHONG Faming; et al.
Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine(Nanchang 330006)
关键词:
经椎间孔入路; 经椎板间入路; 脊柱内镜; 老年; 腰椎间盘突出症
Keywords:
Key words Transforaminal approach; Transinterlaminar approach; Spinal endoscopy; The elderly; Lumbar disc herniation
分类号:
R681.5
文献标志码:
A
摘要:
摘 要 目的：探究经椎间孔入路脊柱内镜下髓核摘除术(PETD)、椎板间入路脊柱内镜下髓核摘除术(PEID)治疗老年L5/S1椎间盘突出症(LDH)的疗效及对患者视觉模拟疼痛(VAS)评分、日本骨科学会腰痛疾患评定表(JOA)评分的影响。方法：将接受脊柱内镜手术治疗的112例老年L5/S1LDH患者根据入路方式不同分为PETD组64例、PEID组48例。于术前，术后1个月、3个月以VAS、JOA评分评估两组腰腿疼痛程度、腰椎功能，并进行疗效评定。结果：两组老年患者手术均成功进行。与PEID组相比，PETD组术中出血量、术中透视次数明显多(P＜005)，术后卧床时间、住院时间比较无统计学差异(P＞005)。PETD组、PEID组并发症发生率分别为7.81%、833%，比较无统计学差异(P＞005)。两组术后1个月、3个月VAS评分、JOA评分均较术前明显改善(P＜005)，但组间比较无统计学差异(P＞005)。PETD组、PEID组术后3个月随访评估优良率达89.06%、87.50%，对比无统计学差异(P＞005)。结论：对于老年L5/S1 LDH患者而言，PETD、PEID均可达到减压、摘除髓核的目的，对缓解腰腿疼痛及改善腰椎功能效果类似，疗效确切、安全，其中PEID具有术中透视次数少、手术时间短的优势，临床应根据两者的解剖特点选择合适入路方式以确保治疗效果。 
Abstract:
Abstract Objective:To explore the curative effect of percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID) in the treatment of elderly patients with L5/S1 lumbar disc herniation (LDH) and the influence on scores of visual analogue pain scale (VAS) and Japanese Orthopaedic Association (JOA). Methods:112 elderly patients with L5/S1 LDH who underwent spinal endoscopic surgery in orthopedics department of the hospital were divided into PETD group (64 cases) and PEID group (48 cases) according to different approach methods. The surgical data were obtained. The degree of lumbar and leg pain,and lumbar function in both groups were evaluated with VAS and JOA scores before surgery and 1 and 3 months after surgery. The curative effect was assessed. Results:The elderly patients in both groups underwent surgery successfully. Intraoperative blood loss and number of intraoperative fluoroscopy in PETD group were significantly more than those in PEID group (P＜0.05). There was no significant difference in bed time and hospital stay after surgery (P＞0.05). The incidence rate of complications in PETD group and PEID group were 7.81% and 8.33%,respectively (P＞0.05).VAS and JOA scores of both groups were significantly improved 1 and 3 months after surgery(P＜0.05),but there was no significant difference between the two groups (P＞0.05). In both groups,the excellent and good rates of followup evaluation 3 months after operation were 89.06% and 8750%,respectively (P＞0.05). Conclusion:For elderly patients with L5/S1 LDH,both PETD and PEID can achieve the purpose of decompression and nucleus pulposus removal. Their effects are similar in relieving lumbar and leg pain,and improving lumbar function. The curative effect is exact and safe. There are advantages of PEID such as little number of intraoperative flu〖LM〗oroscopy and short operation time. Appropriate approach modes should be selected according to anatomical features of the two to ensure the curative effect.

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备注/Memo

备注/Memo:
*江西省卫生和计划生育委员会科研项目（2017D01332）
更新日期/Last Update: 2020-02-17