Different approaches to percutaneous endoscopic lumbar discectomy for L5/S1 lumbar disc herniation: a retrospective study
Different approaches to percutaneous endoscopic lumbar discectomy for L5/S1 lumbar disc herniation: a retrospective study
复制标题
经皮内镜腰椎间盘切除术治疗 L5/S1 腰椎间盘突出症的不同方法：一项回顾性研究。
DOI：
10.1080/02688697.2020.1861218
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发表时间：
2020-12-09
影响因子：
1.1
通讯作者：
Zhang, Daying
中科院分区：
文献类型：
--
作者：
Yan, Yi;Zhu, Mengye;Zhang, Daying
目的观察经椎间和经椎间孔入路经皮内镜下腰椎间盘切除术治疗L5/S1型腰椎间盘突出症（LDH）的手术方法及疗效。方法回顾性研究2016年1月至2018年1月，153例经皮经椎间盘切除术（PETD, n = 84）或经皮经椎间盘切除术（PEID, n = 69）治疗的L5/S1 LDH患者。比较两组穿刺时间、内镜下操作次数、总操作次数及透视次数。采用Oswestry残疾指数（ODI）和视觉模拟量表（VAS）随访2年。比较两组患者并发症发生率、再手术发生率及术后腰痛发生率。结果两组患者一般情况无显著差异。与PEID组相比，PETD组内镜下手术时间减少，穿刺时间、总手术时间、透视次数增加（p < 0.05）。末次随访时，PETD组和PEID组术前VAS评分和ODI评分均下降（p < 0.05）。两组患者术前、末次随访VAS、ODI评分、并发症、再手术发生率比较，差异均无统计学意义（p < 0.05）。PETD组术后腰痛发生率低于PEID组（p < 0.05）。结论L5/S1 LDH的2年临床疗效与PEID相当。与PETD组相比，PEID组穿刺时间、总手术时间和放射照射量均较低，但术后腰痛发生率较高。
ObjectiveTo observe the surgical procedure and outcome of percutaneous endoscopic lumbar discectomy for L5/S1 lumbar disc herniation (LDH) by the interlaminar and transforaminal approach.MethodsA total of 153 patients with L5/S1 LDH who were treated using percutaneous endoscopic transforaminal discectomy (PETD, n = 84) or percutaneous endoscopic interlaminar discectomy (PEID, n = 69) from January 2016 to January 2018 were enrolled in this retrospective study. The time of puncture, operation under the endoscope, total operation and number of fluoroscopy of the two groups were compared. All groups were followed up for two years by using the Oswestry disability index (ODI) and the Visual Analogue Scale (VAS). Additionally, the incidence of complications, reoperation and postoperative low back pain were compared between the two groups.ResultsThere were no significant difference in general information between the two groups. Compared to the PEID group, the PETD group had a decreased operation time under the endoscope and an increased puncture time, total operation time, and the number of fluoroscopy (p < 0.05). The preoperative VAS and ODI scores of the PETD and PEID group were decreased at the last follow-up (p < 0.05). There were no difference in the preoperative or last follow-up VAS and ODI scores, as well as complications, reoperation between the two groups (p > 0.05). The incidence of postoperative low back pain in the PETD group was lower than that in the PEID group (p > 0.05).ConclusionsThe two-year clinical outcome of PETD is equal to that of PEID for L5/S1 LDH. Compared to those with PETD, the puncture time, total operation time and radiation exposure are lower with PEID, but the incidence of postoperative low back pain is higher.