本文選題：PIED　切入點(diǎn)：髓核游離　出處：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2017年09期

【摘要】：目的 :評(píng)價(jià)椎間孔鏡下經(jīng)椎板間入路椎間盤(pán)摘除術(shù)(percutaneous interlaminar endoscopic discectomy,PIED)治療髓核游離型椎間盤(pán)突出的療效。方法:2014年1月—2015年12月接受PIED手術(shù)治療髓核游離型椎間盤(pán)突出患者11例,并獲得完整隨訪資料,隨訪時(shí)間為1年,通過(guò)術(shù)前、術(shù)后1 d、術(shù)后1年的視覺(jué)模擬評(píng)分(visual analogue scale,VAS)、Oswestry功能障礙指數(shù)(Oswestry disability inde,ODI)及改良Mac Nab標(biāo)準(zhǔn)評(píng)價(jià)患者術(shù)后腰腿痛改善情況以及術(shù)前術(shù)后腰椎MRI對(duì)比評(píng)價(jià)髓核摘除效果及復(fù)發(fā)情況。結(jié)果:11例患者手術(shù)成功率為100%。術(shù)前腰痛VAS(7.00±1.00)分,術(shù)后1 d疼痛明顯緩解,VAS(0.55±0.52)分,術(shù)后1年VAS(0.36±0.50)分;術(shù)前平均ODI為(58.55±6.07)%,術(shù)后1 d(4.54±2.25)%,術(shù)后1年為(1.09±1.04)%;改良Macnab標(biāo)準(zhǔn)評(píng)估手術(shù)總體結(jié)果,所有患者接受手術(shù)后癥狀均基本緩解,恢復(fù)了正常工作與生活,優(yōu)良率達(dá)到100%;術(shù)后游離的髓核均被完全摘除,無(wú)復(fù)發(fā)椎間盤(pán)突出者。結(jié)論:PIED能有效治療髓核游離型椎間盤(pán)突出,標(biāo)準(zhǔn)的PIED手術(shù)可以獲得滿意的治療效果。
[Abstract]:Objective: to evaluate the efficacy of percutaneous interlaminar endoscopic discectomytomyd (PIED) in the treatment of free disc herniation of nucleus pulposus by translaminar intervertebral discectomy under transforaminal foramen. Methods: from January 2014 to December 2015, 11 patients with free disc herniation of nucleus pulposus were treated with PIED. Complete follow-up data were obtained. The follow-up time was 1 year. Visual analogue scale and Oswestry disability index (Oswestry disability index) and modified Mac Nab standard were used to evaluate the improvement of postoperative lumbago and leg pain and the preoperative and postoperative MRI to evaluate the effect of nucleus pulposus excision and recurrence. Results the successful rate of operation in 11 cases was 100%. The score of preoperative low back pain was 1. 00 鹵1. 00. The mean ODI was 58.55 鹵6.07 before operation, 4.54 鹵2.25 on 1 day after operation, and 1.09 鹵1.04 on 1 year after operation. The modified Macnab standard was used to evaluate the overall outcome of the operation, and the symptoms of all the patients were basically relieved after operation. The free nucleus pulposus was removed completely after operation, and no recurrent disc herniation was found. Conclusion the free disc herniation of nucleus pulposus can be effectively treated by 1: PIED. The standard PIED procedure can achieve satisfactory results.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院骨科;
【基金】：國(guó)家自然科學(xué)基金(81371970)
【分類(lèi)號(hào)】：R687.3

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