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-  2015 

经皮内镜椎间孔入路微创治疗复发性腰椎间盘突出症疗效分析

DOI: doi:10.7507/1002-1892.20150011

Keywords: 复发性腰椎间盘突出症, 经皮内镜腰椎间盘髓核摘除术, 椎间孔入路, 微创技术

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Abstract:

目的评价经皮内镜椎间孔入路微创治疗复发性腰椎间盘突出症的可行性和有效性。 方法2009年6月-2011年12月,采用经皮内镜椎间孔入路腰椎间盘髓核摘除术治疗复发性腰椎间盘突出症患者56例,其中男30例,女26例;年龄24~70岁,平均50岁。突出节段:L3、4 3例,L4、5 34例,L5~S1 19例。与初次手术同侧突出48例,对侧突出8例。无症状间歇期6个月~27年,平均5.5年。术前采用疼痛视觉模拟评分(visual analogue scale,VAS)评分:腰痛(6.18±1.44)分,腿痛(7.66±1.03)分。患者均在局麻下完成手术,术后随访患者症状改善情况,采用VAS评分、改良MacNab标准评估临床疗效。 结果手术时间30~100min,平均60.4min;住院时间3~6d,平均5.1d。患者均获随访,随访时间24~56个月,平均28.2个月。患者术后即刻疼痛均有不同程度缓解,术后1、3、12个月及末次随访时腰痛及腿痛VAS评分均较术前明显下降,差异有统计学意义(P<0.05)。术后12个月,采用改良MacNab标准评价疗效,获优39例,良9例,可5例,差3例,优良率85.7%。5例(8.9%)术后发生手术相关并发症;1例(1.8%)术后18个月再次复发,行相应节段减压及椎间融合术后症状缓解。 结论经皮内镜椎间孔入路腰椎间盘髓核摘除术可以避开后方瘢痕组织,降低了手术相关并发症的发生率,且创伤小,手术时间短,恢复快,是微创治疗复发性腰椎间盘突出症的有效方法

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