腰椎椎间孔镜微创手术治疗腰椎间盘突出症的临床效果

中国当代医药2019年6月第26卷第16期•骨科医学・腰椎椎间孔镜微创手术治疗腰椎间盘突出症的

临床效果

相东刚

中国科学院大学深圳医院脊柱外科，广东深圳518107

I摘要|目的探讨腰椎椎间孔镜微创手术治疗腰椎间盘突出症的临床效果方法选取我院2016年10月~2018年10月收治的60例腰椎间盘突出症患者作为研究对象，按照随机数字表法分为对照组(30例)与微创组(30例)。

对照组采取常规经后路开放式手术治疗，微创组采取腰椎椎间孔镜微创手术治疗。对患者进行2个月的回访，比较两组患者的手术时长、术中出血量、术后离床活动时间、术前及术后1周的疼痛视觉模拟(VAS)评分、住院期间并发症的发生率、术前及术后2个月的Fugl-Meyer下肢评分和腰部功能障碍指数(ODI)评分。结果微创组的手术时长、术后离床活动时间短于对照组，术中出血量少于对照组，术后1周的VAS评分低于对照组,差异有统计学意义(P<0.001),微创组患者的并发症发生率为3.33%,明显低于对照组的20.00%,差异有统计学意义(P<0.05)。

微创组患者术后2个月的Fugl-Meyer下肢评分明显高于对照组,01)1评分明显低于对照组，差异有统计学意义(P<0.001)。结论在腰椎间盘突出症患者的治疗中采取腰椎间孔镜微创手术，手术用时短，创伤小，术中出血量少,术后并发症较少，恢复迅速，且疼痛较轻.利于下肢功能与腰部功能恢复，效果理想。

［关键词|腰椎椎间；孔镜微创；腰间盘突出；腰部功能评分

冲图分类号］R68155(文献标识码］A［文章编号］1674-4721(2019)6(3)-0125-04

Clinical effect of minimally invasive surgery under lumbar foramen en­doscopy in the treatment of lumbar disc herniation

XIANG Dong-gang

Department of Spinal Surgery,Shenzhen Hospital of University of Chinese Academy of Sciences,Guangdong Province, Shenzhen518107,China

［Abstract］Objective To investigate the clinical effect of minimally invasive surgery under lumbar foramen endoscopy in the treatment of lumbar disc herniation.Methods A total of60patients with lumbar disc herniation admitted to our hospital from October2016to October2018were selected as the research objects.According to the random number table method,they were divided into the control group(30cases)and the minimally invasive group(30cases).The con­trol group was treated with routine open surgery via posterior approach,and the minimally invasive group was treated with minimally invasive surgery under lumbar foramen endoscopy.The patients were followed up for2months.The op­eration time,amount of bleeding during operation,the time of leaving bed after operation,lhe visual analogue scale (VAS)score of pain before and after before and1week after operation,the incidenee of complications during hospital­ization,Fugl-Meyer lower extremity score and Oswestry(lability index(ODI)score of lumbar before and2months cifter operation were compared between the two groups.Results The length of operation,the time of leaving bed after opera­tion in the minimally invasive group were shorter than those in the control group,the amount of bleeding during opera­tion in the mini mall v invasive group was less than that in the control group,and the VAS score in the first week after operation in the minimally invasive group was lower than that in the control group,the difference was statistically sig­nificant(P<0.001).The incidence of complications in the minimally invasive group was3.33%,which was significantly lower than that in the control group(20.00%),the difference was statistically significant(P<0.05).The Fugl-Meyer low­er limb score of the minimally invasive group at2months after operation was significantly higher than that of the con­trol group,and the ODI score of the minimally invasive group at2months after operation was significantly lower than that of the control group,the difference was statistically significant(PcO.001).Conclusion In the treatment of patients with lumbar disc herniation,minimally invasive surgery with lumbar foramen endoscopy has the advantages of short op­eration time,less trauma,less bleeding,less complications and less pain,which is beneficial to the recovery of lower limb function and lumbar function.The effect is ideal.

［Key words］Lumbar intervertebral;Microscopic minimally invasive;Lumbar disc herniation;Lumbar function score

CHINA MODERN MEDICINE Vol.26No.16June2019125