| 微创椎间孔镜治疗伴有坐骨神经痛的腰椎间盘突出症 |
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Received:April 25, 2013
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| 作者 | Author | 单位 | Unit | E-Mail |
| 蒋毅 |
JIANG Yi |
海淀医院骨科, 北京 100080 |
Department of Orthopaedics, Haidian Hospital, Beijing 100080, China |
jy18611126817@hotmail.com |
| 宋华伟 |
SONG Hua-wei |
海淀医院骨科, 北京 100080 |
Department of Orthopaedics, Haidian Hospital, Beijing 100080, China |
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| 王东 |
WANG Dong |
海淀医院骨科, 北京 100080 |
Department of Orthopaedics, Haidian Hospital, Beijing 100080, China |
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| 杨明连 |
YANG Ming-lian |
海淀医院骨科, 北京 100080 |
Department of Orthopaedics, Haidian Hospital, Beijing 100080, China |
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| 期刊信息：《中国骨伤》2013年26卷，第10期，第800-804页 |
| DOI：10.3969/j.issn.1003-0034.2013.10.002 |
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目的: 分析经皮穿刺经椎间孔入路内窥镜下选择性治疗伴有坐骨神经痛的腰椎间盘突出症的临床疗效.
方法: 对2011年6月至2012年1月接受经皮穿刺经椎间孔入路全内窥镜下治疗的46例腰椎间盘突出症患者进行回顾性分析,男28例,女18例;年龄11～77岁,平均(39.7±15.3)岁;其中L5S1 20例,L4,5 26例. 所有患者表现腰痛及下肢放射性坐骨神经痛,术前直腿抬高试验阳性. 术后即刻检查患者直腿抬高试验并记录手术时间、出血量、术中及术后并发症、住院时间、返回工作岗位时间,观察术前,术后1 d及术后3、6、12个月的视觉疼痛评分(visual analog scale,VAS),对术前和末次随访时JOA评分(Japanese orthopedic association score,JOA)及JOABPEQ评分(Japanese orthopedic back pain evaluation questionnaire,JOABPEQ)进行统计学分析以评价其临床疗效.
结果: 所有手术顺利完成,术后即刻直腿抬高试验转为阴性,平均手术时间(93.0±28.0) min,出血量(20.0±9.0) ml,术后住院时间(3.1±1.5) d,返回工作或恢复日常生活时间(11.6±4.2) d.平均随访时间(13.9±1.6)个月,术前,术后1 d,术后3、6、12个月的腰痛VAS评分分别为5.3±1.2,1.9±1.1,1.0±0.8,0.9±0.8,0.8±0.6;腿痛VAS评分分别为7.2±1.2,0.8±1.2,0.5±0.8,0.5±0.8,0.3±0.8;JOABPEQ评分5项指标(腰痛、腰部功能、行走能力、社会生活能力、心理状态)术前分别为27.0±30.6,37.3±27.4,38.5±26.6,33.0±13.7,55.4±19.0;末次随访时分别为83.6±24.8,89.4±15.7,87.0±17.9,58.4±14.6,79. 5±13.4.JOA评分术前及末次随访分别为9.1±2.6及27.3±1.7.各项评分术前术后差异均有统计学意义(P<0.05).
结论: 经皮椎间孔入路镜下治疗伴有坐骨神经痛的腰椎间盘突出安全有效,能迅速缓解患者疼痛,治疗后患者能迅速恢复日常生活及工作. |
| [关键词]:椎间盘移位 坐骨神经痛 外科手术,微创性 内窥镜 |
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| Treatment of lumbar intervertebral disc herniation and sciatica with percutaneous transforaminal endoscopic technique |
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Abstract:
Objective: To analyze the clinical effects of percutaneous transforaminal endoscopic technique in treating lumbar intervertebral disc herniation and sciatica.
Methods: From June 2011 to January 2012,the clinical data of 46 patients with lumbar intervertebral disc herniation and sciatica underwent percutaneous transforaminal endoscopic technique were retrospectively analyzed. There were 28 males and 18 females,ranging in age from 11 to 77 years old with an average of (39.7±15.3) years old,20 cases were L5S1 and 26 cases were L4,5. All patients had the symptoms such as lumbago and sciatica and their straight-leg raising test were positive. Straight-leg raising test of patients were instantly repeated after operation;operative time,volume of blood loss,complication,length of stay and duration of back to work or daily life were recorded. The clinical effects were assessed according to the VAS,JOA and JOABPEQ score.
Results: All operations were successful,postoperative straight-leg raising test were all negative. Operative time,volume of blood loss,length of stay,duration of back to work or daily life,follow-up time were (93.0±28.0) min,(20.0±9.0)ml,(3.1±1.5) d,(11.6±4.2) d,(13.9±1.6) months,respectively. VAS score of lumbar before operation and at the 1st and 3rd,6th,12th month after operation were 5.3±1.2,1.9±1.1,1.0±0.8,0.9±0.8,0.8±0.6,respectively;VAS score of leg before operation and at the 1st and 3rd,6th,12th month after operation were 7.2±1.2,0.8±1.2,0.5±0.8,0.5±0.8,0.3±0.8,respectively. Five factors of JOABPEQ score,including lumbar pain,lumbar function,locomotor activity,social life viability and mental status,were respectively 27.0±30.6,37.3±27.4,38.5±26.6,33.0±13.7,55.4±19.0 before operation and 83.6±24.8,89.4±15.7,87.0±17.9,58.4±14.6,79.5±13.4 at final follow-up. Preoperative and postoperative JOA score were 9.1±2.6 and 27.3±1.7,respectively. The postoperative VAS,JOA and JOABPEQ score had significantly improved(P<0.05).
Conclusion: Percutaneous transforaminal endoscopic technique is safe and effective method in treating lumbar disc herniation and sciatica,it can fleetly relieve pain and the patient can recover daily life and work after treatment. |
| KEYWORDS:Intervertebral disk displacement Sciatica Surgical procedures,minimally invasive Endoscopes |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 蒋毅,宋华伟,王东,杨明连.微创椎间孔镜治疗伴有坐骨神经痛的腰椎间盘突出症[J].中国骨伤,2013,26(10):800~804 |
| 英文格式: | JIANG Yi,SONG Hua-wei,WANG Dong,YANG Ming-lian.Treatment of lumbar intervertebral disc herniation and sciatica with percutaneous transforaminal endoscopic technique[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(10):800~804 |
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