CT导航PELD治疗腰5/骶1极外侧腰椎间盘突出症的研究

CT-navigated PELD in the treatment of L5/S1 extreme lateral lumbar disc herniation

摘要:

摘要：目的：评估CT导航经皮腰椎脊柱内镜治疗腰5/骶1节段极外侧型腰椎间盘突出症的疗效和安全性。方法：纳入2016年9月至2020年2月我科收治的腰5/骶1节段极外侧型腰椎间盘突出，且行CT导航经皮腰椎脊柱内镜手术治疗患者25例，应用疼痛数字模拟评分评估患者术前、术后疼痛变化，Oswestry功能障碍指数评估术前、术后功能恢复情况，同时应用改良改良 Macnab 疗效评价患者整体术后优良率。结果：25 例病人均顺利完成手术，平均手术时间为(80.2±20.6) min，平均住院天数为 (7.3 ±4.5) 天。NRS评分结果显示，患者术后疼痛较术前明显缓解。ODI结果显示，患者术后Oswestry功能障碍指数逐渐下降，功能逐渐恢复。术后12 月 MacNab疗效总体优良率达 96 % (24/25)。随访期间2例（8%）患者因术后再突出复发，再次行内镜手术治疗，术后康复良好。结论：CT导航下经皮腰椎脊柱内镜手术可设计最优手术路径，可安全有效的治疗腰5/骶1节段极外侧型腰椎间盘突出。

Abstract:

Abstract: Objective: To evaluate the efficacy and safety of CT-navigated percutaneous lumbar endoscopic discectomy(PELD) in the treatment of L5/S1 segment extreme lateral lumbar disc herniation(ELLDH). Methods:From September 2016 to February 2020,25 patients with extreme lateral lumbar disc herniation in the L5/S1 segment who underwent CT-navigated PELD were enrolled. Numeric rating scale(NRS) was applied to evaluate the pain score between pre- and post - operation,as well as,The Oswestry dysfunction index(ODI) was used to evaluate the functional recovery. The postoperative excellent and good rate was evaluated by the improved Macnab. Results: All 25 patients successfully completed this operation. The average operation time was (80.2 ± 20.6) min, and the average hospital stay was (7.3 ± 4.5) days. The results of the NRS score showed that the postoperative pain score was significantly decreased compared with that before the operation. ODI results showed that the patient's ODI gradually decreased after the operation, and the function gradually recovered. The MacNab excellent and good rate is 96% (24/25) by the time of 12 months after surgery. During the follow-up period, 2 patients (8%) experienced recurrent and accepted secondary PELD. Conclusion: CT-navigated PELD provides the optimal surgical path , it’s a safely and effectively surgery for L5/S1 ELLDH.