经皮椎间孔镜下髓核摘除术治疗症状性邻近节段退变的疗效分析

摘要

Objective To explore the clinical efficacy of percutaneous transforaminal endoscopic discectomy on symptomatic adjacent segment degeneration .Methods August 2012 to March 2015 ,22 cases of lumbar fusion postoperative symptomatic ad‐jacent segment degeneration in patients with percutaneous transforaminal endoscopic discectomy treatment .Comparative analy‐sis of 22 patients before surgery ,postoperative 1 day ,3 months ,6 months ,9 months VAS scores ODI and the last follow‐up of Macnab ratings .Results All patients completed the operation successfully .follow‐up time for 9‐18 months ,averaging 14.4 months .VAS scores and ODI compared with preoperative postoperative low back pain were significantly reduced ,the difference statistically significant (P<0.05) .The evaluation of Macnab score were excellent in 10 patients ,good in 9 ,fair in 2 ,and poor in 1 ,suggesting an effective rate of 81.8% (19/22) .Conclusion PTED system is an ideal surgical operative method to treat ASD .%目的：探究经皮椎间孔镜下髓核摘除术（percutaneous transforaminal endoscopic discectomy ，PTED）治疗腰椎融合术后症状性邻近节段退变（adjacent segment degeneration ，ASD）的临床疗效。方法选取某院2012年8月至2015年3月收治的22例因腰椎融合术后症状性ASD而行PT ED的患者，比较分析22例患者术前、术后第1天、术后3、6、9个月的腰腿痛视觉疼痛模拟评分（visual analogue scale ，VAS）、功能障碍指数（oswestry disability index ，ODI）以及术后9个月Macanb评分。结果22例患者均获得随访，随访时间9～18个月，平均14.4月。术后VAS评分以及ODI与术前相比均明显降低，差异有统计学意义（P＜0.05）。按MacNab标准，术后9个月随访时优者10例，良者9例，可者2例，差者1例，优良率81.8％（19／22）。结论 PTED治疗腰椎融合术后症状性ASD短期内疗效显著。