| 椎间孔镜下治疗高位腰椎间盘突出症的临床疗效及技术特点 |
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投稿时间：2020-03-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 王峰 |
WANG Feng |
解放军九六○医院骨科, 山东 济南 250000 |
Department of Orthopaedics, the 960 Hospital of Liberation Army, Jinan 250000, Shandong, China |
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| 鞠晓聪 |
JU Xiao-cong |
解放军九六○医院骨科, 山东 济南 250000 |
Department of Orthopaedics, the 960 Hospital of Liberation Army, Jinan 250000, Shandong, China |
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| 宋若先 |
and SONG Ruo-xian |
解放军九六○医院骨科, 山东 济南 250000 |
Department of Orthopaedics, the 960 Hospital of Liberation Army, Jinan 250000, Shandong, China |
ruoxiansong@sina.com |
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| 期刊信息：《中国骨伤》2020年，第33卷，第5期，第430-434页 |
| DOI：10.12200/j.issn.1003-0034.2020.05.008 |
| 基金项目: |
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中文摘要:
目的：分析经皮穿刺椎间孔镜技术治疗高位腰椎间盘突出症（L2，3以上）的临床疗效及技术特点。
方法：回顾性分析2012年1月至2019年10月采用椎间孔镜治疗的9例高位椎间盘突出症患者的临床资料，其中男6例，女3例；年龄26~76岁；L1，2 2例，L2，3 7例。记录手术前后的疼痛视觉模拟评分（visual analogue scale，VAS）和日本骨科协会（Japanese Orthopeadic Association，JOA）评分，并采用改良Macnab标准评价临床疗效。
结果：9例患者术后均获得的随访，术后随访时间为术后第1天和术后3个月。手术操作时间1.5~2.9 h，术后住院天数5~8 d。术中未发生脑脊液漏、脊髓神经损伤事件。9例患者术前，术后第1天，术后3个月VAS评分分别为7~8分，1~3分，0~1分，JOA评分分别为5~7分，15~24分，21~26分。JOA改善率术后1 d为36.4%~78.3%，术后3个月为65.2%~87.5%。术后3个月采用Macnab标准对疗效进行评价，优4例，良4例，可1例。
结论：经皮穿刺椎间孔镜技术治疗符合适应证的高位椎间盘突出症疗效可靠，其具备创伤小，手术时间短等优点，更适合中老年体质差者，可替代部分后外侧经椎间孔椎间盘切除融合术。 |
| 【关键词】高位椎间盘突出症 经皮椎间孔镜腰椎间盘切除术 技术特点 临床疗效 |
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| Clinical efficacy and technical characteristics of percutaneous endoscopic lumbar discectomy in the treatment of upper lumbar disc herniation |
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ABSTRACT
Objective: To analyze the clinical efficacy and technical characteristics of percutaneous endoscopic lumbar discecomy in the treatment of upper lumbar disc herniation.
Methods: The clinical data of 9 patients with upper lumbar disc herniation underwent percutaneous endoscopic lumbar discecomy from January 2012 to October 2019 were retrospectively analyzed. There were 6 males and 3 females,aged 26 to 79 years,including 2 patients with L1,2 disc herniation and 7 patients with L2,3 disc herniation. Visual analogue scale (VAS) and Japanese Orthopeadic Association (JOA) score were recorded before and after surgery. The clinical efficacy was evaluated according to the modified Macnab standard.
Results: All 9 patients were followed up,and the follow-up time was 1 day and 3 months after surgery. The operation time was 1.5 to 2.9 h and postoperative hospital stay was 5 to 8 d. No cerebrospinal fluid leakage or spinal cord injury occurred during the operation. Preoperative and postoperative at 1 day,3 months,the VAS scores of 9 patients were 7 to 8 scores,1 to 3 scores,0 to 1 case,JOA scores were 5 to 7 scores,15 to 24 scores,21 to 26 scores,respectively. The improvement rate of JOA was 36.4% to 78.3% on the first day and 65.2% to 87.5% three months after operation. According to modified Macnab standard to evaluate effect,4 cases got excellent results,4 good,1 fair.
Conclusion: Percutaneous endoscopic lumbar discecomy has reliable therapeutic effect for upper lumbar disc herniation in line with the indications,and it has the characteristics of small trauma and short operation time,so it is more suitable for middle-aged and elderly patients with poor physique and can replace part of transforaminal lumbar interbody fusion. |
| KEY WORDS Upper intertebral disc herniation Percutaneous endoscopic lumbar discectomy Technical characteristics Clinical efficacy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王峰,鞠晓聪,宋若先.椎间孔镜下治疗高位腰椎间盘突出症的临床疗效及技术特点[J].中国骨伤,2020,33(5):430~434 |
| 英文格式: | WANG Feng,JU Xiao-cong,and SONG Ruo-xian.Clinical efficacy and technical characteristics of percutaneous endoscopic lumbar discectomy in the treatment of upper lumbar disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(5):430~434 |
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