内镜下经椎板间隙与经椎间孔治疗L5/S1腰椎间盘突出症的对比研究-东南大学学报医学版

内镜下经椎板间隙与经椎间孔治疗L5/S1腰椎间盘突出症的对比研究

单位：1. 东南大学医学院, 江苏南京 210009;
2. 东南大学附属中大医院脊柱外科, 江苏南京 210009

分类号：R681.53

出版年·卷·期（页码）：2018·37·第五期（829-834）

摘要：

目的：探讨经椎板间隙与经椎间孔治疗L5/S1腰椎间盘突出症的手术过程和疗效差异。方法：2年时间内纳入我院99例L5/S1腰椎间盘突出症患者，根据自愿选择分为经椎板间隙组（IL-PELD组）和经椎间孔组（TF-PELD组），其中IL-PELD组46例，TF-PELD组53例。两组分别行手术治疗，记录手术时长和术中透视次数，术前、术后1 d、术后3个月评估患者的腰、腿痛VAS及JOA评分，计算优良率，行相关检验评价差异。结果：手术均顺利完成，IL-PELD组的手术时长和术中透视次数均明显低于TF-PELD组，术后两组患者的腰、腿痛VAS及JOA评分都较术前明显改善，IL-PELD组对腰痛的改善优于TF-PELD组。结论：内镜下经椎板间隙腰椎间盘切除术治疗L5/S1腰椎间盘突出症效果明显，可以明显改善患者的腰、腿痛症状，优良率高。

Objective:To investigate the surgical process and curative effect of endoscopic interlaminar and transforaminal lumbar discectomy for lumbar intervertebral disc herniation(L5/S1). Methods:In two years 99 cases of lumbar intervertebral disc herniation(L5/S1) patients were treated by endoscopic interlaminar or transforaminal lumbar discectomy according to their choice, and finally there were 46 patients in interlaminar group and 53 patients in transforaminal group. The operative time, X-ray times and postoperative back-leg pain VAS score, JOA score, excellent rate were compared between the two groups. Results:The operation duration and X-ray times of interlaminal group were significantly lower than those of the transforaminal group. Postoperative VAS score of back-leg pain and JOA score were significantly improved compared with the preoperative both in two groups, the VAS score of back pain of interlaminal group was better than transforaminal group. Conclusion:Endoscopic interlaminar lumbar discectomy for treatment of lumbar intervertebral disc herniation(L5/S1) has great effect, can significantly relieve the patient's back-leg pain, and has great excellent rate.

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