经皮椎间孔镜与椎板开窗髓核摘除术治疗腰椎间盘突出症的临床疗效比较

目的:探讨和比较经皮椎间孔镜与椎板开窗髓核摘除术治疗腰椎间盘突出症的临床效果和安全性。方法:回顾性分析2011年-2014年我院收治的明确诊断为腰椎间盘突出症并行经皮椎间孔镜或椎板开窗髓核摘除术患者192例,其中118例给予经皮椎间孔镜治疗(PELD组),74例给予椎板开窗髓核摘除术(对照)。结合随访资料,评价并比较两组患者在术前后的VAS疼痛评分、Mac Nab疗效、Lehmann腰椎功能评分及住院时间、费用、手术出血量以及并发症的发生情况。结果:两组患者的术后疼痛评分、Lehmann腰椎功能评分、Mac Nab疗效、总费用、手术时间比较均无统计学差异(P0.05),但PELD组术中出血量、切口长度、并发症的发生率均较对照组降低或减小,差异有统计学意义(P0.05)。结论:经皮椎间孔镜技术作为一种新型微创脊柱外科技术,能够在保证良好疗效的前提下,明显减少出血及并发症,在临床工作中可以进一步的开展。

Comparison of the Clinical Efficacy of Percutaneous Endoscopic Lumbar Discectomy and Limited Electric Drill Discectomy in the Treatment of Lumbar Disc Herniation

Objective:To compare the clinical effect and safety of Percutaneous Endoscopic Lumbar Discectomy (PELD) with limited electric drill discectomy in the treatment of patients with lumbar disc herniation.Methods:192 cases of patients with lumbar disc herniation treated from 2011 to 2014 were retrospectively reviewed, in which 118 patients were treated by PELD and 74 patients were treated by limited electric drill discectomy(control). The clinical outcomes were evaluated and compared by visual analogue scale(VAS), Lehmann Lumbar function score, modified Macnab criteria, routine operation indicators and incidence of complications between two groups.Results:The VAS score, lumbar function and total cost of patients who were treated by PELD was similar to that of patients treated by limited electric drill discectomy (P>0.05). The time in hospital, intraoperative blood loss and incidence of complications were shorter or lower in PELD group compared with the cobtrol group (P<0.05).Conclusion:PELD had obvious advantages of some aspects in the treatment of lumbar disc herniation, which could be further carried out in clinic.