经皮椎间孔镜技术治疗伴马尾神经症状的腰椎间盘突出症OA

Objective To explore the efficacy of percutaneous transforaminal endoscopic discectomy(PTED)for treat-ment of lumbar disc herniation complicated with cauda equina symptoms.Methods The 21 patients with lumbar disc herniation complicated with cauda equina nerve symptoms were treated with PTED.Among them,14 cases were mainly characterized by urinary and fecal disorders,abnormal sensation in the sellar region,and 7 cases were mainly charac-terized by decreased muscle strength in both lower limbs.The improvement of the cauda equina symptoms were recored.Pain VAS was used to evaluate lumbar and leg pain,and ODI score was used to evaluate patient quality of life.Results All patients were followed up for 1～6 years.The 14 cases who suffered from preoperative symptoms of the cauda equina were mainly characterized by urinary and fecal disorders,abnormal sensation in the sellar region,the improvement time of postoperative symptoms was0.5～14(4.26±2.09)months;the 7 cases with preoperative symptoms of the cauda equina,the main manifestation was a decrease in muscle strength in both lower limbs.At 1 year follow-up after surgery,except for one case who had no change in muscle strength at grade 0,the remaining 6 cases showed improvement in muscle strength,compared to before surgery.The pain VAS and ODI scores for lower back and leg pain were lower than preoperative scores at 1 year after surgery(P<0.05).Conclusions PTED treatment for lumbar disc herniation complicated with cauda equina symptoms shows significant improvement in symptoms,with sat-isfactory clinical efficacy.