关月红 1吴健 2汪李军 2徐斌 2唐健 3张英 3何颖琦1
作者信息
- 1. 常熟市第二人民医院康复科,江苏 常熟 215500
- 2. 常熟市第二人民医院脊柱骨科,江苏 常熟 215500
- 3. 常熟市第二人民医院麻醉科,江苏 常熟 215500
- 折叠
摘要
Abstract
Objective To explore the clinical efficacy of conventional transforaminal endoscopic technique and I See transforaminal endoscopic technique in the treatment of recurrent L5S1 lumbar disc herniation with high iliac crest.Methods A total of 36 patients with recurrent L5S1 lumbar disc herniation with high iliac crest after posterior small-incision discectomy,ad-mitted from May 2016 to May 2023,were selected.They were divided into the conventional transforaminal endoscopy group and the I See transforaminal endoscopy group according to the different transforaminal endoscopic techniques adopted,and all patients in both groups underwent lateral transforaminal spinal canal decompression and discectomy.There were 18 patients in the conventional transforaminal endoscopy group,including 11 males and 7 females,with an age of(52.24±6.68)years;the I See transforaminal endoscopy group also had 18 patients,including 12 males and 6 females,with an age of(50.75±7.79)years.The perioperative indicators(operation time,number of intraoperative radiographs,and length of hospital stay)were compared between two groups.The clinical efficacy was evaluated using the visual analogue scale(VAS)for pain,the Japanese Or-thopaedic Association(JOA)low back pain score,and the modified MacNab criteria before and after surgery.Results All pa-tients achieved grade Ⅰ incision healing,with no infection cases.The operation time of the I See group was(64.25±16.67)minutes,which was significantly shorter than that of the conventional transforaminal endoscopy group(89.11±17.24)minutes,and the difference was statistically significant(P＜0.05).The number of intraoperative radiographs in the I See group was(5.20±2.29)times,which was significantly less than that in the conventional transforaminal endoscopy group(19.16±3.68)times,and the difference was statistically significant(P＜0.05).The VAS and total JOA scores of both groups at the 3rd day,the 3rd month after surgery,and the last follow-up were significantly lower than those before surgery,with statistically significant differences(P＜0.05);however,there were no statistically significant differences in VAS and total JOA scores between two groups at the 3rd day,the 3rd month after surgery,and the last follow-up(P＞0.05).According to the modified MacNab criteria for efficacy evaluation:in the conventional transforaminal endoscopy group,14 cases were excellent and 4 cases were good;in the I See transforaminal endoscopy group,15 cases were excellent and 3 cases were good;there was no statistically significant difference in efficacy between two groups(Z=0.177,P=0.674).Conclusion Both transforaminal endoscopic techniques have good clinical effects in the treatment of recurrent L5S1 lumbar disc herniation with high iliac crest,resulting in significant im-provement of postoperative symptoms,and they are safe,reliable,and minimally invasive surgical methods.Compared with the conventional transforaminal endoscopy,the I See transforaminal endoscopic technique has shorter operation time and fewer in-traoperative radiographs,so it is generally the first choice.关键词
椎间盘突出/复发/高髂嵴/外科手术/椎间孔镜Key words
Lumbar disc herniation/Recurrent/High iliac crest/Surgical operation/Transforaminal endoscopy分类
医药卫生
