两种内镜术式治疗腰椎巨大椎间盘突出比较

Percutaneous endoscopic interlaminar discectomy versus percutaneous endoscopic transforaminal discectomy for huge lum⁃ bar disc herniation

摘要:

[目的] 比较采用经皮内镜椎板间入路椎间盘切除 （percutaneous endoscopic interlaminar discetomy, PEID） 与经皮内镜椎间孔入路椎间盘切除 （percutaneous endoscopic transforaminal discetomy, PETD） 治疗巨大腰椎间盘突出症的临床效果。[方法]回顾性分析 2016 年 9 月—2019 年 9 月本院骨科接受内镜腰椎髓核摘除术治疗的巨大腰椎间盘突出症 159 例患者的临床资料，其中，84 例接受 PEID，75 例接受 PETD 组。比较两组临床效果。[结果]两组患者均顺利完成手术。两组手术时间、术中出血量、透视次数、下地时间及住院时间的差异均无统计学意义（P＞0.05）。末次随访时两组患者 VAS 和 ODI 评分均较术前显著减小（P＜0.05），相应时间点两组间 VAS 和 ODI 评分的差异均无统计学意义（P＞0.05）。[结论]两种术式均可有效治疗巨大型腰椎间盘突出症。

Abstract:

[Objective] To compare the clinical outcomes of percutaneous endoscopic interlaminar discectomy (PEID) versus percutane- ous endoscopic transforaminal discectomy (PETD) for huge lumbar disc herniation. [Methods] A retrospective study was conducted on 159 patients who received endoscopic discectomy for huge lumbar disc herniation from September 2016 to September 2019 in our department. Among them, 84 patients received PEID, while the other 75 patients received PETD. The clinical consequences were compared between the two groups. [Results] All the patients in both groups had operation completed successfully, without significant differences in terms of opera- tive time, intraoperative blood loss, fluoroscopic times, ambulation time and hospital stay between the two groups (P＞0.05). At the last followup, both VAS and ODI scores in the two groups were significantly decreased compared with those before surgery (P＜0.05). However, there were no statistical significantly differences in VAS and ODI scores between 2 groups at any corresponding time points (P＞0.05). [Conclusion] Both the endoscopic discectomies do effectively treat huge lumbar disc herniation in this study.