经皮椎间孔镜TESSYS技术与经后路椎板开窗髓核摘除术临床效果对比研究

摘要/Abstract

摘要： 目的探究与分析经皮椎间孔镜TESSYS技术与经后路椎板开窗髓核摘除术的手术疗效及影像学变化。方法选取2020年5月—2022年6月泰安市中医医院收治的90例接受腰椎间盘切除术的患者,按照不同的手术操作方法分为观察组和对照组,各45例。观察组给予经皮椎间孔镜下TESSYS技术治疗,对照组给予经后路椎板开窗髓核摘除术治疗,对比两组治疗效果。结果观察组与对照组相比术中出血量较少,切口长度较短,术后VAS评分较低,神经根损伤率较低,随访1年复发率较低,随访1年后腰椎不稳定发生率以及临近节段退变率均较低,差异有统计学意义（P<0.05）。两组改良的Macnab 优良率相比,差异无统计学意义（P>0.05）。结论经皮椎间孔镜下TESSYS技术实施腰椎间盘切除术治疗腰椎间盘突出症的临床效果显著,切口较小,对周围组织伤害较小,疼痛轻,促进预后。

关键词: 经皮椎间孔镜, TESSYS技术, 腰椎间盘切除术, 经后路椎板开窗髓核摘除术

Abstract: Objective To explore and analyze the comparative study of surgical efficacy and imaging changes between percutaneous transforaminal endoscopic TESSYS technology and posterior laminectomy for nucleus pulposus. Methods According to different surgical procedures, 90 patients receiving lumbar discectomy admitted to Tai 'an Hospital of Traditional Chinese Medicine from May 2020 to June 2022 were divided into 45 patients in each group. The observation group was given percutaneous transforaminal TESSYS technology, while the control group was given posterior fenestrated laminae nucleus pulposus extraction. The therapeutic effects of the two groups were compared. Results Compared with the control group, the observation group had less intraoperative blood loss, shorter incision length, lower postoperative VAS score, lower nerve root injury rate, lower recurrence rate at 1 year follow-up, and lower incidence of lumbar instability and adjacent segment degeneration after 1 year follow-up, with statistical significance (P<0.05). There was no significant difference in the excellent and good rate of improved Macnab between the two groups (P>0.05). Conclusion The clinical effect of percutaneous lumbar discectomy using TESSYS technology under intervertebral foramen is significant for the treatment of lumbar disc herniation. The incision is small, the damage to surrounding tissues is small, the pain is mild, and the short-term follow-up imaging performance is good, which can promote prognosis.

Key words: percutaneous foraminoscope, TESSYS technology, lumbar discectomy, fenestration via posterior laminae nucleus pulposus

中图分类号:

R687.3

公维兴, 任晓璇, 闫虎. 经皮椎间孔镜TESSYS技术与经后路椎板开窗髓核摘除术临床效果对比研究[J]. 中华养生保健, 2024, 42(10): 159-162.

GONG Wei-xing, REN Xiao-xuan, Yan Hu. Comparative Study on the Clinical Effect of Percutaneous Transforaminal TESSYS Technique and Posterior Fenestration of the Laminae Nucleus Pulposus[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(10): 159-162.

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