经皮椎间孔镜与传统椎板开窗髓核摘除术在复发性腰椎间盘突出症的疗效对比分析

摘要

Objective To investigate the effect of percutaneous lumbar intervertebral disc herniation in the treatment of recurrent lumbar disc herniation,and to compare with the traditional method of surgical treatment of lumbar disc herniation.Methods From July 2013 to September 2015,the clinical data of 90 patients with recurrent lumbar disc herniation were retrospectively analyzed.According to the different ways of patients with reoperation,the patients were divided into traditional laminectomy discectomy group (control group,37 cases) and percutaneous transforaminal endoscopic discectomy group (observation group,53 cases).The indicators of the two groups were compared.Results All patients were successfully completed surgery.After operation,1 patient in the observation group occurred intervertebral infection,healed after anti inflammation treatment.2 patients in control group had lower extremity nerve symptoms,after given neurotrophic hormone,dehydration treatment,the symptoms were improved.There was no significant difference in the incidence of complications between the two groups (x2=1.867;P=0.172).The operation time and length of hospital stay in the observation group were significantly shorter than those in the control group,with less bleeding and shorter incision length,and the differences between the two groups were statistically significant (P＜0.01).Compared with before operation,the twoindicators at each time point after operation in two groups were significandy improved (P＜0.05),but the differences were not statistically significant (P＞0.05).Conclusion The two surgery methods in the treatment of recurrent lumbar disc herniation have similar effect,but the percutaneous transforaminal endoscopicdiscectomy has short operation time,less trauma,fast recovery and other advantages.%目的 探讨经皮椎间孔镜技术在复发性腰椎间盘突出症的应用效果,并与传统的椎板开窗髓核摘除术式进行疗效对比,探讨其优势.方法 回顾性分析2013-07-2015-09收治的90例复发性腰椎间盘突出症患者,依据患者再次手术方式的不同,分为传统椎板开窗髓核摘除术组(对照组,37例)和经皮椎间孔镜组(观察组,53例).对两组患者相关指标进行对比.结果 两组患者均顺利完成手术,术后观察组1例患者出现椎间隙感染,经抗炎治疗后痊愈;对照组2例出现下肢神经症状加重,予以营养神经、激素与脱水治疗后好转.(1)两组的并发症发生率对比,差异无统计学意义(x2=1.867;P=0.172).(2)观察组的手术时间、住院时间均显著短于对照组,出血量更少、切口长度更短,两组差异均有显著的统计学意义(P＜0.01).(3)两组术后各时间点与组内术前对比,两项指标均有显著性改善(P＜0.05);但组间差异无统计学意义(P＞0.05).结论 两组术式在复发性腰椎间盘突出症的手术疗效相当,但经皮椎间孔镜手术具有手术时间短、创伤小、术后恢复快等明显优势.