【摘要】 目的探讨脊柱内镜外科化理念治疗腰椎间盘突出症的临床效果。方法回顾性分析2018年1月至2019年8月我院收治的有典型神经根受压症状的腰椎间盘突出症患者120例,均为单节段病灶,其中60例采用脊柱内镜外科化理念治疗(外科化理念组),60例采用普通脊柱内镜下髓核摘除术治疗(普通内镜组),观察两组手术指标,包括手术时间、术中出血量、术后住院时间。比较两组患者术后1个月、3个月、半年、1年患肢的VAS评分及Oswestry功能障碍指数(ODI)。结果手术均顺利完成,外科化理念组术中出血量及术后住院时间明显低于普通内镜组(P<0.05),但外科化理念组的手术时间明显高于普通内镜组(P<0.05);两组术后1个月、3个月下肢痛VAS评分及Oswestry功能障碍指数比较,差异无统计学意义(P>0.05);外科化理念组术后6个月VAS评分为(1.4±0.3)分、术后1年VAS评分为(1.5±0.4)分,显著低于普通内镜组,两组比较,差异有统计学意义(P<0.05);外科化理念组术后6个月ODI评分为(13.7±4.8)分、术后1年ODI评分为(13.5±4.6)分,均显著低于普通内镜组,两组比较,差异有统计学意义(P<0.05)。结论脊柱内镜外科化理念治疗腰椎间盘突出症是安全、有效的方法,相比普通脊柱内镜下髓核摘除术有更好的中远期效果。更多还原

【Abstract】 Objective To investigate the clinical effect of the surgical concept of spinal endoscopy in the treatment of lumbar disc herniation. Methods From January 2018 to August 2019, a total of 120 cases of lumbar disc herniation with typical nerve root compression symptoms treated in our hospital were retrospectively analyzed, all of which were single-segment lesions. 60 cases underwent endoscopic spinal surgery based on the surgical concept(the incision length of the surgical concept group). 60 cases were treated with ordinary spinal endoscopic nucleus pulposus(the ordinary endoscopy group). The surgical indicators of the two groups were observed, including operation time, intraoperative blood loss, postoperative hospital stay. The VAS scores of the affected limbs and the oswestry disability index(ODI) at one month, three months, six months, and one year after operation were compared between the two groups. Results The operations were successfully completed. The blood loss and postoperative hospital stay of the surgical concept group was significantly less than that of the ordinary endoscopy group(P<0.05). The operation time of the surgical concept group was significantly higher than that of the ordinary endoscopy group(P<0.05). There were no significant differences in VAS score of lower limb pain and the Oswestry dysfunction index between the two groups at one month and three months after surgery(P>0.05). The VAS score in the surgical concept group at six months after the operation(1.4±0.3) and one year after the operation(1.5±0.4) was significantly lower than those in the ordinary endoscopy group, and the difference between the two groups was statistically significant(P<0.05). The ODI score at six months after the operation(13.7±4.8) and one year after the operation(13.5±4.6) in the surgical concept group were significantly lower than those in the ordinary endoscopy group. The difference between the two groups was statistically significant(P<0.05). Conclusion The surgical concept of spinal endoscopy is a safe and effective method to treat lumbar disc herniation, which has better mid-and long-term results than ordinary spinal endoscopic nucleus extraction.更多还原