| 吴钒,李志钢,徐彬,等.椎间孔镜下纤维环缝合术治疗青少年腰椎间盘突出症的临床疗效研究.骨科,2023,14(6): 501-505. |
| 椎间孔镜下纤维环缝合术治疗青少年腰椎间盘突出症的临床疗效研究 |
| Clinical Efficacy of Percutaneous Transforaminal Endoscopic Discectomy Combined with Annulus Fibrosus Suture on Adolescent Lumbar Disc Herniation |
| 投稿时间：2023-05-02 |
| DOI：10.3969/j.issn.1674-8573.2023.06.003 |
| 中文关键词: 椎间孔镜 椎间盘切除术 纤维环缝合术 青少年 腰椎间盘突出症 脊髓神经功能 |
| 英文关键词: Transforaminal endoscopic discectomy Diskectomy Annulus fibrosus suture Adolescents Lumbar disc herniation Spinal cord function |
| 基金项目:吴阶平医学基金会临床科研专项基金项目（320.6750.2021-06-14）；湖北省中西医结合医院“杏林人才工程”院级科研青年项目（H2023Q002） |
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| 中文摘要: |
| 目的 探讨经皮椎间孔镜技术（PTED）联合纤维环缝合术治疗青少年腰椎间盘突出症（ALDH）的临床疗效。方法 对2017年1月至2021年12月在湖北省中西医结合医院骨科行手术治疗的67例ALDH病人的临床资料进行回顾性分析，其中行PTED联合纤维环缝合术治疗的37例纳入观察组，同期行常规PTED的30例纳入对照组。比较两组术前、术后6个月和术后1年的腰腿痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI），以及胫神经、腓总神经的潜伏期与神经传导速度；比较两组术后1年的改良MacNab评分优良率与复发率。结果 病人随访（14.2±1.7）个月（12~24个月）。观察组术后6个月、术后1年的VAS评分、ODI指数均优于对照组；胫神经、腓总神经的潜伏期均低于对照组，神经传导速度均高于对照组；两组比较，差异均有统计学意义（P＜0.05）。观察组和对照组术后的复发率分别为5.41%、6.67%，术后1年手术优良率分别为94.59%、93.33%，两组比较，差异均无统计学意义（P＞0.05）。结论 PTED联合纤维环缝合术治疗ALDH病人可取得满意的手术效果，可有效降低医源性组织损伤，改善腰腿痛症状及腰椎功能，促进术后脊髓神经功能快速恢复。 |
| 英文摘要: |
| Objective To investigate the effect of percutaneous transforaminal endoscopic discectomy (PTED) combined with annulus fibrosus suture on adolescent lumbar disc herniation (ALDH). Methods A total of 67 ALDH patients in Hubei Provincial Hospital of Integrated Chinese and Western Medicine from January 2017 to December 2021 were selected for a retrospective study. Thirty-seven patients treated with PTED combined with annulus fibrosus suture were included in the observation group, 30 patients undergoing PTED were included in the control group. The lumbocrural pain visual analogue scale (VAS) and Oswestry disability index (ODI) before operation, 6 months and 12 months after operation were compared. The incubation period and nerve conduction velocity of the tibial nerve and the common peroneal nerve before operation, 6 months and 12 months after operation were compared between the two groups. The MacNab good or excellent rate and recurrence rate of the two groups one year after surgery were compared. Results The follow-up time was (14.2±1.7) months (12-24 months). In the observation group, the VAS score and ODI at 6 months and 1 year after operation were better, the latency of the tibial nerve and common peroneal nerve was lower, and the nerve conduction velocity was higher than those in the control group with the differences between the two groups being statistically significant (P＜0.05). The recurrence rate after surgery was 5.41% in the observation group and 6.67% in the control group, and the excellent rate of surgery was 94.59% in the observation group and 93.33% in the control group (P＞0.05). Conclusion PTED combined with annulus fibrosus suture can achieve satisfactory surgical results in the treatment of ALDH patients, has the advantages of less iatrogenic tissue damage, and can effectively improve the symptoms of lumbar and leg pain, lumbar spine function and quick postoperative recovery. Moreover, it has the advantages of promoting the rapid recovery of spinal nerve function after surgery. |
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