【摘要】 目的比较经皮椎间孔镜下后路椎板间入路及侧后方椎间孔入路治疗腰5/骶1椎间盘突出症的疗效,并评估其临床应用价值。方法将24例腰5/骶1椎间盘突出症患者随机分为后路椎板间入路12例及侧后方椎间孔入路12例,并进行0.5~2年的临床随访,以评价不同入路方式的治疗效果与临床价值。结果 24例患者平均随访时间12个月。经椎板间组较经椎间孔组患者手术时间短,术中出血量少,C臂照射次数少,差异均有统计学意义(均P<0.05)。术后1个月和末次随访,两组患者VAS评分差异无统计学意义(P>0.05)。Macnab评分:经椎板间组术后1个月优良率为83.3%,末次随访优良率为91.7%,经椎间孔组术后1个月优良率为91.7%,末次随访优良率为91.7%,两组间比较,差异无统计学意义(均P>0.05)。结论经皮椎间孔镜下后路椎板间入路是一种安全、有效、微创的治疗方案。后路椎板间入路较侧后方椎间孔入路更加简单,且可减少手术时间及透视次数,具有临床推广应用价值。更多还原

【Abstract】 Objective To explore the clinical effects of discectomy with transforaminal endoscope through interlaminar approach and transforaminal approach for L5/S1 lumbar disc herniation.Methods 22 patients with L5/s1 lumbar disc herniation were divided into groupe of the interlaminar approach and the transforaminal approach with a follow-up of1-2years.Results 22 cases were followed up with an average of 12 months.Compare to the transforaminal approach groupe,the interlaminar approach grpupe had shorter operative time、less blood loss and shotrer X-ray irradiation times(P<0.05);the two groups in 1month postoperative and latest follow-up,the lumbar functional rating score,VAS score had no significant differences compared with pre-operation(P>0.05);In interlaminar approach group,the excellent rate was 83.3%in 1month post-operation and 91.7%in latest follow-up.In control group,the excellent rate was 91.7%in1month transforaminal approach and 91.7% in latest follow-up,there was no significant differences between the two groupes(P>0.05).Conclusion The discectomy with transforaminal endoscope through interlaminar approach for lumbar disc herniation is a safe,effective and minimally invasive therpy.Compare to the transforaminal approach,the interlaminar approach is more simple,and can decrease operative time and X-ray irradiation times.更多还原