| 侧路经皮椎间孔镜技术在腰椎后路术后再次手术中的应用 |
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Received:September 17, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 姚辉 |
YAO Hui |
中山大学附属第三医院岭南医院骨科, 广东 广州 510100 |
Department of Orthopaedics, Lingnan Hospital, the Third Affiliated Hospital of University, Guangzhou 510100, Guangdong, China |
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| 徐义春 |
XU Yi-chun |
中山大学附属第三医院岭南医院骨科, 广东 广州 510100 |
Department of Orthopaedics, Lingnan Hospital, the Third Affiliated Hospital of University, Guangzhou 510100, Guangdong, China |
xuyichun18@163.com |
| 陈碧英 |
CHEN Bi-ying |
中山大学附属第三医院岭南医院骨科, 广东 广州 510100 |
Department of Orthopaedics, Lingnan Hospital, the Third Affiliated Hospital of University, Guangzhou 510100, Guangdong, China |
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| 侯刚 |
HOU Gang |
中山大学附属第三医院岭南医院骨科, 广东 广州 510100 |
Department of Orthopaedics, Lingnan Hospital, the Third Affiliated Hospital of University, Guangzhou 510100, Guangdong, China |
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| 赵慧清 |
ZHAO Hui-qing |
中山大学附属第三医院岭南医院骨科, 广东 广州 510100 |
Department of Orthopaedics, Lingnan Hospital, the Third Affiliated Hospital of University, Guangzhou 510100, Guangdong, China |
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| 期刊信息：《中国骨伤》2015年28卷，第8期，第712-716页 |
| DOI：10.3969/j.issn.1003-0034.2015.08.008 |
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目的:探讨侧路经皮椎间孔镜技术(transforaminal endoscopic spine system,TESSYS)在腰椎后路术后再次手术中的应用效果。
方法:自2012年1月至2013年10月,根据纳入标准,筛选14例腰椎后路术后需要再次手术的患者,应用TESSYS治疗。其中男8例,女6例;年龄27～84岁,平均(50.4±18.9)岁。观察比较手术前后视觉疼痛模拟评分 (visual analogue scale,VAS)及日本骨科协会评分 (Japanese Orthopaedic Association Scores,JOA评分),并采用改良的Macnab标准评估疗效。
结果:所有患者获得随访,时间6～27个月,平均18个月。术前及术后1周,3、6个月的VAS分别为6.79±1.31,2.50±1.29,2.21±1.53,1.64±1.08,术后与术前比较差异有统计学意义(P <0.01);JOA评分分别为12.43±1.95,21.50±3.78,21.93±4.55,23.36±4.33,术后较术前明显提高(P <0.01).按改良的Macnab 标准评定,优5例,良7例,可1例,差1例。1例穿刺过程中损伤L5神经根,其余患者无并发症。
结论:选择合适的病例,在腰椎后路术后再次手术中应用TESSYS治疗,可以成功避开初次手术瘢痕,减少并发症,取得满意的临床效果。 |
| [关键词]:腰椎 再手术 外科手术,微创性 |
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| Surgical revision of lumbar vertebrae using transforaminal endoscopic spine system |
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Abstract:
Objective:To explore the clinical effects of transforaminal endoscopic spine system in surgical revision of lumbar vertebrae.
Methods:From January 2012 to October 2013,14 patients who needed reoperations of lumbar vertebrae were treated using transforaminal endoscopic spine system(TESSYS). There were 8 males and 6 males,aged from 27 to 84 years old with an average of(50.4±18.9) years. Visual analogue scale(VAS) and Japanese Orthopaedic Association Scores (JOA) were compared before and after surgical revision. Macnab standard was used to assess the clinical effect.
Results:All the patients were followed up from 6 to 27 months with the mean of 18 months. Preoperative VAS score was 6.79±1.31,and in a week,3 months and 6 months after operation were 2.50±1.29,2.21±1.53,1.64±1.08,respectively,which were all much lower(P <0.01) than preoperative score. Preoperative JOA score was 12.43±1.95,and the above corresponding postoperative JOA scores were 21.50±3.78,21.93±4.55,23.36±4.33,respectively,which were all much higher than preoperative score(P <0.01). According to the modified Macnab criteria,5 patients got an excellent results,7 good,1 fair and 1 poor. The nerve root injury of L5 occurred in 1 case during paracentesis and no other complications were found.
Conclusion:Selecting the appropriate indications using TESSYS in surgical revision of lumbar vertebrae can successfully avoid the operation scar,reduce the surgical complications and obtain satisfactory clinical outcomes. |
| KEYWORDS:Lumbar vertebrae Reoperation Surgical procedures,minimally invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 姚辉,徐义春,陈碧英,侯刚,赵慧清.侧路经皮椎间孔镜技术在腰椎后路术后再次手术中的应用[J].中国骨伤,2015,28(8):712~716 |
| 英文格式: | YAO Hui,XU Yi-chun,CHEN Bi-ying,HOU Gang,ZHAO Hui-qing.Surgical revision of lumbar vertebrae using transforaminal endoscopic spine system[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(8):712~716 |
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