| 经皮椎间孔镜TESSYS技术治疗单节段双侧腰椎间盘突出症 |
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投稿时间：2018-06-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 邓洪利 |
DENG Hong-li |
西安市红会医院脊柱微创科, 陕西 西安 710054 |
Spinal Minimally Invasive Department, Xi'an Honghui Hospital Xi'an 710054, Shaanxi, China |
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| 高文杰 |
GAO Wen-jie |
西安市红会医院脊柱微创科, 陕西 西安 710054 |
Spinal Minimally Invasive Department, Xi'an Honghui Hospital Xi'an 710054, Shaanxi, China |
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| 朱金文 |
ZHU Jin-wen |
西安市红会医院脊柱微创科, 陕西 西安 710054 |
Spinal Minimally Invasive Department, Xi'an Honghui Hospital Xi'an 710054, Shaanxi, China |
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| 王晓东 |
WANG Xiao-dong |
西安市红会医院脊柱微创科, 陕西 西安 710054 |
Spinal Minimally Invasive Department, Xi'an Honghui Hospital Xi'an 710054, Shaanxi, China |
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| 周劲松 |
ZHOU Jin-song |
西安市红会医院脊柱微创科, 陕西 西安 710054 |
Spinal Minimally Invasive Department, Xi'an Honghui Hospital Xi'an 710054, Shaanxi, China |
jszhou_1st@sina.com |
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| 期刊信息：《中国骨伤》2018年，第31卷，第11期，第1041-1045页 |
| DOI：10.3969/j.issn.1003-0034.2018.11.011 |
| 基金项目: |
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中文摘要:
目的：探讨经椎间孔镜TESSYS（transforaminal endoscopic spine system）技术治疗单节段双侧腰椎间盘突出症患者的早期临床效果。
方法：对2016年2月至2018年2月行经皮椎间孔镜TESSYS技术治疗的单节段双侧腰椎间盘突出症38例患者进行回顾性分析，男26例，女12例；年龄30~55（35.2±6.4）岁；L3，4 6例，L4，5 22例，L5S1 10例。使用德国Joimax GmbH公司椎间孔镜，局部麻醉，透视下双侧穿刺至病变节段的椎间孔外侧，应用4级扩张导管逐级完成椎间孔扩大成形，环锯逐级扩大椎间孔，双侧置入椎间孔镜，摘除突出髓核，直至神经根完全松解。术后对患者进行定期的门诊复查、电话随访，分别比较术前、术后1、3、6、12个月的双下肢疼痛的视觉模拟疼痛评分（VAS）、Oswestry功能障碍指数（Oswestry Disability Index，ODI），末次随访应用改良的MacNab标准进行疗效评定。
结果：36例患者手术顺利且获得12个月以上的随访。术后1、3、6、12月的双下肢疼痛VAS评分和ODI评分较术前均有明显改善（P<0.05），术后1、3个月与术后6、12个月双下肢疼痛的VAS评分和ODI评分差异均有统计学意义（P<0.05），而术后1个月与3个月、术后6个月与12个月双下肢疼痛VAS评分和ODI评分差异无统计学意义（P>0.05），末次随访根据改良MacNab评价标准，优14例，良16例，可4例，差2例。
结论：运用经皮椎间孔镜TESSYS技术从双侧摘除突出髓核的同时能够充分对神经根进行减压，可以有效应用于单节段双侧腰椎间盘突出症的患者。 |
| 【关键词】椎间盘移位 TESSYS技术 外科手术,微创性 |
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| Percutaneous transforaminal endoscopic TESSYS technique for the treatment of bilateral lumbar disc herniation in single segment |
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ABSTRACT
Objective: To investigate the early clinical effects of transforaminal endoscopic spine system (TESSYS) for the treatment of bilateral lumbar disc herniation in single segment.
Methods: The clinical data of 38 patients with single-segment bilateral lumbar disc herniation treated by TESSYS technique from February 2016 to February 2018 were retrospectively analyzed. There were 26 males and 12 females, aged from 30 to 55 years old with an average of (35.2±6.4) years, 6 cases of L3, 4, 22 cases of L4, 5, and 10 cases of L5S1. Using the intervertebral foramen endoscope produced by Joimax GmbH, Germany, under local anesthesia, bilateral puncture to the outside of the intervertebral foramen of the diseased segment, four-stage dilatation catheter to complete the progressive enlargement of the intervertebral foramen, and the ring saw progressively enlarge the intervertebral foramen. The bilateral foramen was placed and the herniated nucleus was removed until the nerve root was completely released. Postoperatively, the patients were reviewed on regular outpatient visits and telephone follow-ups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were compared before operation and after operation at 1, 3, 6, 12 months respectively. At the final follow-up, according to modified MacNab criteria to evaluate the clinical effect.
Results: Thirty-six patients underwent successful surgery and were followed up for more than 12 months. The ODI score and VAS score of the lower extremities pain at 1, 3, 6, 12 months after operation were obviously improved (P<0.05), there was significant difference between 1, 3 months and 6, 12 months after operation (P<0.05), there was no significant difference between 1 and 3 months, between 6 and 12 months after operation (P>0.05). At the final follow-up, according to MacNab criteria, 14 cases got excellent results, 16 good, 4 fair, 2 poor.
Conclusion: Using TESSYS technique to remove the bilateral herniated nucleus from single segment can fully decompress for the nerve root, and can be effectively applied to patients with single-segment bilateral lumbar disc herniation. |
| KEY WORDS Intervertebral disk displacement TESSYS technique Surgical procedures,minimally invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邓洪利,高文杰,朱金文,王晓东,周劲松.经皮椎间孔镜TESSYS技术治疗单节段双侧腰椎间盘突出症[J].中国骨伤,2018,31(11):1041~1045 |
| 英文格式: | DENG Hong-li,GAO Wen-jie,ZHU Jin-wen,WANG Xiao-dong,ZHOU Jin-song.Percutaneous transforaminal endoscopic TESSYS technique for the treatment of bilateral lumbar disc herniation in single segment[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(11):1041~1045 |
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