经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的临床疗效及术后复发的影响因素分析

目的:探讨经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症(LDH)的临床疗效,分析术后复发的影响因素.方法:选取我院于2017年2月～2019年12月期间收治的LDH患者230例,均给予经皮椎间孔镜下髓核摘除术治疗,观察其疗效、不同时间点视觉疼痛模拟评分量表(VAS)、Oswestry功能障碍指数(ODI)评分及并发症.记...

Clinical Efficacy of Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation and Influencing Factors of Postoperative Recurrence

Objective: To investigate the clinical efficacy of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation(LDH), and to analyze the influencing factors of postoperative recurrence. Methods: 230 cases of LDH patients in our hospital from February 2017 to December 2019 were selected. All patients were treated with percutaneous transforaminal endoscopic discectomy. The curative effect, visual analogue scale(VAS) at different time points, Oswestry disability index(ODI) score and complications observed. The recurrence rate of LDH(PRLDH) was recorded. The influencing factors of PRLDH were analyzed by univariate and multivariate Logistic regression analysis. Results: Among 230 patients with LDH after treatment by percutaneous transforaminal endoscopic discectomy, 69 cases were excellent, 117 cases were good, 34 cases were fair and 10 cases were poor. The excellent and good rate was 80.87%(186/230). The VAS and ODI scores of LDH patients at 3 months and 6 months after operation were gradually decreased compared with those before operation, VAS and ODI scores decreased from 3 months to 6 months after operation, the differences were statistically significant(P<0.05). The incidence rate of postoperative complications of LDH patients was5.22%(12/230). There were 29 patients with PRLDH, the recurrence rate was 12.61%(29/230). Univariate analysis showed that PRLDH was related to age, smoking, body mass index, diabetes mellitus, nucleus pulposus and course of disease(P<0.05). Multivariate Logistic regression analysis showed that age ≥60 years old, smoking, body mass index ≥ 24 kg/m², diabetes mellitus, prolapse of nucleus pulposus/prolapse, course of disease ≥6 months were the influencing factors of PRLDH(P<0.05). Conclusion: Percutaneous transforaminal discectomy in the treatment of LDH, the curative effect is stable, can better promote the improvement of pain symptoms,accelerate the recovery of lumbar function, however, attention should be paid to the postoperative recurrence. Age ≥60 years old,smoking, body mass index ≥24 kg/m², diabetes mellitus, prolapse of nucleus pulposus/prolapse, course of disease ≥6 months are the influencing factors of PRLDH.