可视化环锯椎间孔成形术在侧入路单通道内镜下椎间盘髓核摘除术治疗腰椎间盘突出症中的应用研究OA
A Study on the Application of Visualised Circular Saw Foraminoplasty in the Treatment of Lumbar Disc Herniation via Side-entry Single-channel Endoscopic Discectomy for Intervertebral Disc Nucleus Removal
目的:探讨可视化环锯椎间孔成形术在侧入路单通道内镜下椎间盘髓核摘除术治疗腰椎间盘突出症(LDH)中的效果,旨在为临床寻找有效、安全、便捷的手术治疗方法提供依据.方法:将罗定市人民医院骨科 2024 年 8 月—2026 年 1 月收治并拟行侧入路单通道内镜下椎间盘髓核摘除术的 60 例LDH 患者作为研究对象,按照随机数字表法将纳入研究对象分为对照组、研究组,每组 30 例,对照组采用传统透视环锯椎间孔成形术,研究组采用可视化环锯椎间孔成形术.观察与比较两组手术指标、腰和下肢 VAS 评分、Oswestry 功能障碍指数(ODI)评分、手术优良率、关节突成形面积比及术后并发症发生情况.结果:两组术中出血量、住院时间比较,差异无统计学意义(P>0.05),研究组手术时间为(77.45±12.38)min,短于对照组的(94.78±14.09)min,术中透视次数为(8.05±2.22)次,少于对照组的(11.45±3.05)次(P<0.05).研究组术后 24 h 的腰 VAS 评分和下肢 VAS 评分均低于对照组(P<0.05);两组患者出院前 1 d 的 ODI 评分、术后 3 个月手术优良率、术后 24 h 关节突成形面积比及术后并发症发生率比较,差异无统计学意义(P>0.05).结论:可视化环锯椎间孔成形术在侧入路单通道内镜下椎间盘髓核摘除术治疗LDH中,能在保障手术效果基础上,提高手术效率、降低放射暴露和术后疼痛.
Objective:To investigate the efficacy of visualised circular saw foraminoplasty in the treatment of lumbar disc herniation(LDH)via side-entry single-channel endoscopic discectomy for intervertebral disc nucleus removal,with the aim of providing evidence to support the development of effective,safe and convenient surgical treatment methods for clinical practice.Method:The study included 60 patients with LDH admitted to the Department of Orthopaedics of Luoding People's Hospital from August 2024 to January 2026 and scheduled to undergo side-entry single-channel endoscopic discectomy for intervertebral disc nucleus removal.Using a random number table method,the subjects were divided into a control group and a study group,with 30 patients in each group.The control group underwent traditional perspective circular saw foraminoplasty,the study group underwent visualised circular saw foraminoplasty.The surgical parameters,VAS scores for lumbar and lower limb,Oswestry disability index(ODI)scores,the excellent and good rates,the ratio of facet joint reshaping area,and the incidence of postoperative complications between the two groups were observed and compared.Result:There were no statistically significant differences between the two groups in terms of intraoperative blood loss and hospital stay duration(P>0.05).The operative time in the study group was(77.45±12.38)minutes,which was shorter than that in the control group[(94.78±14.09)minutes],the number of fluoroscopic views during surgery was(8.05±2.22)times,which was lower than that in the control group[(11.45±3.05)times](P<0.05).The study group exhibited lower lumbar VAS scores and lower limb VAS scores at 24 hours postoperatively compared to the control group(P<0.05).There were no statistically significant differences between groups in ODI scores one day prior to discharge,the excellent and good rate at 3 months after operation,facet joint reshaping area ratios at 24 hours after operation,and postoperative complication incidence(P>0.05).Conclusion:Visualised circular saw foraminotomy via side-entry single-channel endoscopic discectomy for intervertebral disc nucleus removal in treating LDH enhances surgical efficiency,reduces radiation exposure and postoperative pain while maintaining therapeutic efficacy.
温锐灿;陈宁;梁俊芳;李国兴;莫楚鸿;沈梓维;李结嫦;贾燕梅;张允烨
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医药卫生
腰椎间盘突出症可视化环锯椎间孔成形术单通道侧入路
Lumbar disc herniationVisualisationCircular sawForaminoplastySingle-channelSide-entry
《中国医学创新》 2026 (25)
12-16,5
广东省云浮市科技计划项目(WS2024030202)
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