Delta大通道内镜腰椎间盘切除术的临床研究△

A clinical study on delta large channel endoscope used for lumbar discectomy

摘要:

[目的] 评价Delta 大通道内镜手术治疗腰椎间盘突出症的临床疗效。[方法] 回顾性分析2020 年1 月—2021 年10月接受Delta 大通道内镜治疗腰椎间盘突出症73 例患者的临床资料。评估临床及影像结果。[结果] 所有患者手术顺利完成。手术时间平均（78.1±24.0） min，术中透视次数平均（3.3±1.0） 次，患者平均随访时间（18.2±5.3） 个月。与术前相比，术后3 个月和末次随访时腰痛VAS [(5.6±1.8), (1.8±1.0), (1.1±0.9), P＜0.001] 及腿痛VAS 评分[(7.5±1.5), (1.3±1.0), (1.1±0.8), P＜0.001]、ODI[(70.3±15.7), (15.2±10.3), (7.6±6.0), P＜0.001]、JOA 评分[(10.3±3.3), (20.9±2.0), (23.8±3.3), P＜0.001] 均显著改善。影像方面，与术前相比，末次随访时腰椎前凸角度无显著变化（P＞0.05），但是椎间盘高度指数[(26.6±4.9)%, (28.2±5.2)%, P＜0.001] 显著增加。[结论] Delta 大通道内镜治疗腰椎间盘突出症的疗效总体满意，可作为临床上治疗腰椎间盘突出症的微创手术方式。

Abstract:

[Objective] To evaluate the clinical efficacy of discectomy under delta large channel endoscope in the treatment of lumbardisc herniation. [Methods] A retrospective study was conducted on 73 patients who received the large-channel endoscopic discectomy forlumbar disc herniation from January 2020 to October 2021. The clinical and imaging data were evaluated. [Results] All the patients weresuccessfully operated with the average operative time of (78.1±24.0) min, intraoperative fluoroscopy of (3.3±1.0) times, and followed up for(18.2±5.3) months. Compared with those preoperatively, back pain VAS [(5.6±1.8), (1.8±1.0), (1.1±0.9), P＜0.001], leg pain VAS score [(7.5±1.5), (1.3±1.0), (1.1±0.8), P＜0.001], ODI [(70.3±15.7), (15.2±10.3), (7.6±6.0), P＜0.001], JOA score [(10.3±3.3), (20.9±2.0), (23.8±3.3), P＜0.001] significantly improved 3 months postoperatively and at the last follow-up. Radiographically, the lumbar lordosis remained unchangedat the last follow-up compared with that before surgery (P＞0.05), but the intervertebral disc height index increased significantly [(26.6±4.9)%, (28.2±5.2)%, P＜0.001]. [Conclusion] The delta endoscopy achieves generally satisfactory consequences in the treatment of lumbardisc herniation, and is a minimally invasive surgical method.