【摘要】 目的 探讨经皮椎间孔镜技术与传统椎板开窗技术治疗复发性腰椎间盘突出症(Recurrent lumbar disc herniation, RLDH)的疗效。方法 选取我院2018年12月～2020年12月收治的复发性腰椎间盘突出症患者114例，按再次手术方式不同分为孔镜组和开窗组。孔镜组56例行经皮椎间孔镜术治疗，开窗组58例行传统椎板开窗术治疗，两组术后均随访6～22个月，平均(13.82±4.45)个月。比较两组患者围手术期相关指标(手术时间、手术切口长度、出血量、术后卧床时间、住院时间)、术前和术后第3天、3个月及末次随访时的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)及并发症发生情况。结果 两组患者均顺利完成手术。孔镜组的手术时间、手术切口长度、术后卧床时间和住院时间均显著短于开窗组，出血量少于开窗组，组间比较差异具有统计学意义(均P<0.05)。两组患者术后的VAS、ODI与术前比较均有明显改善，差异均有统计学意义(均P<0.05)。术后第3天及3个月时，孔镜组的VAS评分均低于开窗组(均P<0.05),而两组末次随访时比较差异无统计学意义(P>0.05)。术后第3天，孔镜组的ODI低于开窗组(P<0.05),而两组术后3个月及末次随访时比较差异无统计学意义(均P>0.05)。两组并发症发生率比较，差异无统计学意义(P>0.05)。结论 两种手术方式治疗复发性腰椎间盘突出症早期均有效，但经皮椎间孔镜技术治疗可缩短手术时间，其损伤更小，术后康复更快。更多还原

【Abstract】 Objective To Discussing the efficiencies between the Percutaneous transforarminal endoscopic discectomy and the traditional fenestration discectomy of recurrent lumbar disc herniation(RLDH). Methods From December 2018 to December 2020,114 patients with disc herniation recurrence underwent Percutaneous transforarminal endoscopic discectomy who were set to transforarminal endoscopic group(n=56)and traditional fenestration group(n=58).All patients received follow-up 6-22 months with an average of(13.82±4.45)months.The comparative analysis included operation time, incision length, amount of bleeding, postoperative bed days, hospital days, the VAS and ODI before and after surgery, surgical complications, etc. Results The operations were successfully had in both groups.The transforarminal endoscopic group had shorter surgical time, shorter incision length, less bleeding volume, postoperative bed time and hospitalization time than those in the traditional fenestration group, which was statistical significance(P<0.05 for each).The postoperative VAS and ODI were obviously improved in the two groups, with statistically significant difference(P<0.05 for each)too.The 3-days and 3-months postoperative VAS of the transforarminal endoscopic group were below than those of the traditional fenestration groupwith statistically significant(P<0.05 for each);While the VAS in the last follow-up between the two groups, it was not statistically significant(P>0.05).The transforarminal endoscopic group had postoperative ODI below the traditional fenestration group, which was statistical significance(P<0.05),While the ODI of 3 months after operation and at the last follow-up between the two groups, there were not statistically significant(P>0.05).Complication rates were similar in both groups. Conclusion Both of the two surgical methods are effective in the early treatment of recurrent lumbar disc herniation, but percutaneous intervertebral foraminal endoscopy can shorten the operation time, reduce the injury, and recover faster after operation.更多还原