[1]丁永国,李昌隆,孙建民,等.经皮穿刺椎间孔镜下应用TESSYS技术治疗 腰椎间盘突出症的临床疗效观察[J].医学信息,2018,31(16):38-42.[doi:10.3969/j.issn.1006-1959.2018.16.011]
　DING Yong-guo,LI Chang-long,SUN Jian-min,et al.Clinical Observation of Percutaneous Lumbar Disc Herniation Treated by TESSYS Technique under Transforaminal Endoscopy[J].Journal of Medical Information,2018,31(16):38-42.[doi:10.3969/j.issn.1006-1959.2018.16.011]
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经皮穿刺椎间孔镜下应用TESSYS技术治疗 腰椎间盘突出症的临床疗效观察()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年16期
页码:
38-42
栏目:
论著
出版日期:
2018-08-15

文章信息/Info

Title:
Clinical Observation of Percutaneous Lumbar Disc Herniation Treated by TESSYS Technique under Transforaminal Endoscopy
文章编号:
1006-1959（2018）16-0038-05
作者:
丁永国1; 李昌隆1; 孙建民1; 李可心2; 胡海平1; 满 毅1; 甄龙龙1; 常 慧1
1.宁夏回族自治区第三人民医院疼痛科，宁夏 银川 750000； 2.宁夏医科大学总医院皮肤科，宁夏 银川 750000
Author(s):
DING Yong-guo1; LI Chang-long1; SUN Jian-min1; LI Ke-xin2;  HU Hai-ping1; MAN Yi1; ZHEN Long-long1; CHANG Hui1
1.Department of Pain,the Third People's Hospital of Ningxia Hui Autonomous Region,Ningxia 750000,Yinchuan,China; 2.Department of Dermatology,General Hospital of Ningxia Medical University,Ningxia 750000,Yinchuan,China
关键词:
腰椎间盘突出症; 微创; 脊柱内镜; TESSYS技术
Keywords:
Key words：Lumbar disc herniation; Minimally invasive; Spinal endoscopy; TESSYS technique
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2018.16.011
文献标志码:
A
摘要:
目的 评估经皮穿刺椎间孔镜下采用TESSYS技术治疗椎间盘突出的短期临床疗效。方法 选择2017年1月~8月宁夏回族自治区第三人民医院采用椎间孔镜系统治疗腰椎间盘突出症62例，观察患者年龄、病程、手术时间、术后引流量、术后恢复情况，比较手术前后患者VAS、ODI、JOA评分。结果 62例患者手术顺利，无转为开放手术病例。平均手术时间（74.84±18.74）min，平均住院时间（8.52±1.52）d；随访3~6个月，术前、术后及末次随访时VAS评分分别为（8.20±1.14）分、（2.01±0.86）分和（1.13±0.64）分；JOA评分分别为（10.13±2.56）分、（22.57±1.69）分和（23.72±1.27）分；ODI评分分别为（40.46±5.55）分、（11.97±2.52）分和（9.13±1.48）分。术后3个月及末次随访时与术前比较，统计学意义显著（P＜0.01）。改良Macnab标准评价临床效果优56例，良5例，可1例。MacNab标准优良率达到98.39%。术后髓核残留1例，发生率为1.61%，术后复发3例，发生率为4.84%，术后神经根性痛觉过敏10例，发生率为16.13%，术后脑脊液漏患者2例，发生率为3.23%。59例患者末次随访时症状均无复发。结论 通过椎间孔镜下手术操作后，术后VAS、ODI、JOA与术前比较均显著改善，术中出血量较的传统手术有明显下降，微创手术缩短下地时间，降低了术后并发症的发生率，提高了患者的功能恢复的质量。
Abstract:
Abstract：Objective To evaluate the short-term clinical efficacy of percutaneous transforaminal use of TESSYS in the treatment of intervertebral disc herniation.Methods From January to August 2017,62 cases of lumbar disc herniation were treated by intervertebral foraminoscope system in Ningxia Third People's Hospital of Hui Autonomous Region.The patients'age,course of disease, operation time,postoperative drainage and postoperative recovery were observed. VAS,ODI and JOA scores were compared before and after operation.Results 62 patients underwent successful operation without conversion to open surgery.The average operation time was (74.84±18.74)min,the average hospital stay was(8.52±1.52)d;the follow-up period was 3-6 months,the VAS scores were(8.20±1.14), (2.01±0.86)and(1.13±0.64)before,after and at the last follow-up.The JOA scores were(10.13±2.56)and(22.57±1.69),respectively.The scores were(23.72±1.27);the ODI scores were(40.46±5.55),(11.97±2.52)and(9.13±1.48),respectively.At 3 months after the operation and at the last follow-up,statistically significant(P<0.01).The improved Macnab standard evaluation was excellent in 56 cases,good in 5 cases,and fair in 1 case.The excellent rate of MacNab standard reached 98.39%.1 case of residual nucleus pulposus was performed, the incidence rate was 1.61%,3 cases were recurred,the incidence rate was 4.84%,10 cases of postoperative radiculopathy hyperalgesia,the incidence rate was 16.13%,and 2 cases of postoperative cerebrospinal fluid leakage occurred.The rate is 3.23%. There were no recurrences in the symptoms of the 59 patients at the last follow-up.Conclusion After operation under the operation of the intervertebral foramen,the postoperative VAS,ODI,JOA and the preoperative comparison were significantly improved.The intraoperative blood loss was significantly lower than the traditional operation.The minimally invasive surgery shortened the time of the lowering of the ground and reduced the postoperative complications.The incidence of the disease improves the quality of the patient's functional recovery.

参考文献/References:

[1]Sun Y,Zhang W,Qie S,et al.Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study[J].Medicine (Baltimore),2017,96(29):e7471.
[2]张之栋,杜怡斌,储建军.经皮椎间孔镜腰椎间盘摘除术与微创经椎间孔腰椎融合术治疗腰椎间盘突出症的前瞻性随机对照研究[J].中国微创外科杂志,2015,15(07):583-587.
[3]Ruetten S,Komp M,Merk H,et al.Use of newly developed instruments and endoscopes:full-endoscopic resection of lumbardisc herniations via the interlaminar and lateral transforaminal approach[J].J Neurosurg Spine,2007,6(6):521-530.
[4]尹西盟,穆胜凯,吴岩,等.经皮椎间孔镜与开放减压手术治疗老年腰椎椎管狭窄症疗效对比[J].脊柱外科杂志,2014(05):293-297.
[5]裴博.经皮椎间孔镜技术治疗有典型根性症状的稳定型腰椎滑脱症的临床疗效[J].中国实用医药,2015(36):159-160.
[6]Chen HC,Lee CH,Weil,et al.Comparison of percutaneous endoscopic lumbar discectomy and open lumbar surgery for adjacent segment degenration and recurrent disc herniation[J].Neurol Res Int,2015(2018):791973.
[7]张西峰,张琳.脊柱内镜技术的历史、现状与发展[J].中国疼痛医学杂志,2015,21(02):81-85.
[8]Lee S,Kim SK,Lee SH,et al.Percutaneous endoscopic lumbar discectomy for migrated disc herniation:classification of disc migration and surgical approaches[J].Eur Spine J,2007,16（3）:431-437.
[9]吕振,姜树东,白金柱,等.电学治疗在脊髓损伤领域从基础研究转化为临床技术的研究进展[J].首都医科大学学报,2015,36(5):805-808.
[10]黄承飞,吴耀持.针灸治疗腰椎间盘突出症局部炎症作用机制的研究进展[J].湖南中医杂志,2012,28(4):171-174.
[11]陆仕恒.MED和PELD治疗腰椎间盘突出症的疗效随访与分析[D].广西中医药大学,2017.
[12]Cho JY,Lee SH,Lee HY.Prevention of development of postoperative dysesthesia in transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation: floating retraction technique [J].Minim Invasive Neurosurg, 2011, 54(5-6):214-218.

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更新日期/Last Update: 2018-08-15