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經(jīng)皮椎間孔鏡下腰椎手術(shù)治療腰椎間盤(pán)突出和腰椎管狹窄的臨床效果

發(fā)布時(shí)間:2023-03-04 04:49
  背景:腰椎間盤(pán)突出癥和腰椎管狹窄癥是最常見(jiàn)的年齡相關(guān)性脊柱疾病。經(jīng)皮椎間孔鏡下腰椎手術(shù)是目前治療該疾病最新的微創(chuàng)手術(shù)方式。目的:探討經(jīng)皮椎間孔鏡下腰椎手術(shù)對(duì)腰痛患者的治療效果,并進(jìn)一步評(píng)價(jià)該手術(shù)對(duì)不同年齡段、不同性別及不同診斷的腰痛患者的療效差異。材料與方法:該回顧性研究共納入257例2013至2017年于我院行經(jīng)皮椎間孔鏡下腰椎手術(shù)的患者,其中腰椎間盤(pán)突出癥患者206例,腰椎管狹窄癥患者51例,在這257例患者中,男性153例,女性104例;年齡≤55歲151例,年齡>55歲106例。平均隨訪(fǎng)時(shí)間為19.78月。結(jié)果:入組患者平均手術(shù)時(shí)間為80.12±23.91分鐘,平均住院時(shí)間為4.33±1.94天。術(shù)前和術(shù)后的ODI指數(shù)有明顯差異(56.27±15.23,8.94±11.06,p<0.05)。術(shù)前、術(shù)后下肢VAS評(píng)分(6.70±1.15,0.83±1.30,p<0.05)、背部VAS評(píng)分(5.83±1.44,0.73±1.18,p<0.05),均有顯著差異。參照MacNab標(biāo)準(zhǔn)評(píng)價(jià),79.4%的患者療效滿(mǎn)意,14%的患者療效一般,6.6%的患者療效較差。通...

【文章頁(yè)數(shù)】:93 頁(yè)

【學(xué)位級(jí)別】:碩士

【文章目錄】:
ACKNOWLEDGEMENT
DEDICATION
ABSTRACT
摘要
PREFACE
ABBREBIATIONS
CHAPTER 1: INTRODUCTION
    1.1. Overview
        1.1.1. Lumbar Disc Herniation
        1.1.2. Lumbar Spine Stenosis
        1.1.3. Background of Percutaneous Endoscopic Lumbar Spine Surgery
    1.2. The Purpose of the Research
CHAPTER 2: LITERATURE REVIEW
    2.1. Anatomy of Vertebral body
        2.1.1. Vertebral Body
        2.1.2. Intervertebral disc
        2.1.3. Spinal Ligaments
        2.1.4. Spinal Nerve
        2.1.5. Other structures
    2.2. Low Back Pain
        2.2.1. Overview
        2.2.2. Sign and symptoms
        2.2.3. Causes
        2.2.4. Pathophysiology
        2.2.5. Diagnosis
        2.2.6. Management
    2.3. Literature Discussion:
        2.3.1. Percutaneous Transforaminal Endoscopic Lumbar Spine Surgery for Lumbar Disc Herniation
        2.3.2. Percutaneous Transforaminal Endoscopic Lumbar Spine Surgery for Lumbar Stenosis
CHAPTER 3: RESEARCH ANALYSIS
    3.1. Research Design and methodology
        3.1.1. Research Design, Method and Data collection:
        3.1.2. Population, Sample and Sampling Techniques
        3.1.3. Statistical Analysis
    3.2. Surgical Procedure (Percutaneous Transforaminal Endoscopic Lumbar Spine Surgery)
        3.2.1. Surgical Equipment/Instruments
        3.2.2. Surgical (Transforaminal) Technique:
    3.3. Clinical Evaluation
        3.3.1. The Oswestry Disability Index (ODI) [142]
        3.3.2. A Visual Analogue Scale (VAS) [144]
        3.3.3. Macnab criteria[144]
    3.4. Result and Data Interpretation
        3.4.1. Overall analysis on preoperative and postoperative patient’s conditions treated with transforaminal approach
        3.4.2. Analysis of preoperative and postoperatively patient’s conditions on the basis of gender.
        3.4.3. Analysis of clinical outcome between LDH and LSS cases treated with transforaminal approach
55 years old age undergone PTELS with transforaminal approach">        3.4.4. Analysis of clinical outcome of patients of £55years old and >55 years old age undergone PTELS with transforaminal approach
    3.5. DISCUSSION
    3.6. CONCLUSION
REFERENCE



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