生物骨科材料与临床研究2017，Vol.14Issue(2)：21-25,5.DOI:10.3969/j.issn.1672-5972.2017.02.005
经皮穿刺椎间孔镜下髓核摘除术-前100例临床经验
Percutaneous endoscopic discectomy-clinical experience with the first 100 cases
黄伟敏 1于秀淳 1宋若先 1张晶涛1
作者信息
- 1. 济南军区总医院骨病科,山东济南250031
- 折叠
摘要
Abstract
Objective To investigate the clinical outcome and experience of percutaneous endoscopic discectomy in the early stage.Methods The first 100 patients who underwent percutaneous endoscopic discectomy via transforaminal approach in our hospital from Jan 2013 to May 2014 were retrospectively studied.There were 59 males and 41 females with mean age of (33.2±6.1) years (range from 18 to 63 years).There were 23 cases with middle lumbar disc herniation,60 cases with lateral lumbar disc herniation,5 cases with far lateral lumbar disc herniation,7 cases with caudal migrated lumbar disc herniation and 5 cases with calcified lumbar disc herniation.With regard to index level,there were 5 cases at the L3/4,60 cases at the L4/5,31 cases at the L5/S1,4 cases at the L4/5 and L5/S1,and 1 case at the L3/4 and L4/5.The learning curves were evaluated by puncturing time,endoscopic operating time,and fluoroscopy times.Clinical outcome were evaluated by Japanese Orthopedic Association (JOA) scores and Visual Analogue Scale (VAS) preoperatively,at 1 day,3 months and 12 months postoperatively.The complications were also recorded.Results The mean follow-up period was 12.3 months (range from 9 to 15 months).The mean puncturing time was (28.4±11.7) minutes (range from 15 to 100 minutes) and the mean endoscopic operating time was (38.6±12.2) minutes (range from 15 to 90 minutes).The mean fluoroscopy times were (9.1±3.1) (range from 4 to 51).The JOA score increased from preoperative mean (10.5±3.1) to mean (25.2±3.3) at 12 months postoperatively.The VAS score decreased from preoperative mean (8.3±2.1) to mean (1.7±0.5) at 12 months postoperatively.2 cases had dural tear,1 case suffered from recurrent lumbar disc herniation.1 case demonstrated intervertebral metallic artifacts on MRI scans at 1 week postoperatively,but no metallic debris was detected on the CT scans and the patient was asymptomatic during the follow-up periods.Conclusion Percutaneous endoscopic discectomy has a steep leaming curve.Clinical outcome on the early stage was satisfactory.关键词
椎间孔镜/腰椎间盘突出症/临床疗效/并发症Key words
Percutaneous endoscopic discectomy/Learning curve/Clinical outcome/Complication分类
医药卫生引用本文复制引用
黄伟敏,于秀淳,宋若先,张晶涛..经皮穿刺椎间孔镜下髓核摘除术-前100例临床经验[J].生物骨科材料与临床研究,2017,14(2):21-25,5.
