Application of selective foraminoplasty in percutaneous endoscopic lumbar discectomy for far lateral lumbar disc herniation
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Application of selective foraminoplasty in percutaneous endoscopic lumbar discectomy for far lateral lumbar disc herniation
nullIssue 7, Pages: 553(2019)
作者机构:
1. 陆军军医大学特色医学中心脊柱外科,重庆,400042
2. 重庆市急救医疗中心,重庆市第四人民医院,重庆大学附属中心医院骨科,重庆,400014
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Published:2019,
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PU Jungang, FAN Weili, CHAO Rui, et al. Application of selective foraminoplasty in percutaneous endoscopic lumbar discectomy for far lateral lumbar disc herniation. [J]. null (7):553(2019)
DOI:
PU Jungang, FAN Weili, CHAO Rui, et al. Application of selective foraminoplasty in percutaneous endoscopic lumbar discectomy for far lateral lumbar disc herniation. [J]. null (7):553(2019)DOI:
Application of selective foraminoplasty in percutaneous endoscopic lumbar discectomy for far lateral lumbar disc herniation
Objective To provide the basis for whether the foraminoplasty should be performed or not in the treatment of percutaneous endoscopic lumbar discectomy according to the clinical classification of far lateral lumbar disc herniation. Methods From January 2013 to March 2016
52 patients with far lateral lumbar disc herniation were treated by percutaneous endoscopic lumbar discectomy via posterior lateral approach.According to the locations of the herniated disc
it can be divided into type Ⅰ
Ⅱ
Ⅲ and Ⅳ.The patients with type Ⅱ recieved the operation plan A without foraminoplasty(group A
n=21)
while patients with type Ⅰ
Ⅲ and Ⅳ received the operation plan B with foraminoplasty(group B
n=31).The operation time
bleeding volume and complications of the two groups were recorded.Visual analogue scale(VAS) and Oswestry disability index(ODI) were used to evaluate the pain and dysfunction of patients before operation
3 days
3 months after operation and the last followup.Macnab criteria was used to evaluate the clinical efficacy at the last followup. Results All 52 patients successfully received the operationwithout serious complications such as postoperative infection and intraoperative nerve root injury and tear of the dural sac.The operation time and the amount of bleeding in group A were less than those in group B
the differences were significant(P<0.05).All patients were followed up for 6 to 24 months
with an average of (11±2.3)months.VAS score of low back pain and leg pain and lumbar ODI score at 3 days
3 months and the last followup after operation were significantly different from those before operation(P<0.05).In the last followup
the Macnab efficacy score showed that 41 cases were excellent
9 cases were good and 2 cases were acceptable.The excellent and good rate was 96.15%. Conclusion The clinical classification of far lateral lumbar disc herniation is of great significance for understanding the pathological changes of the disease and the selection of surgery methods for percutaneous endoscopic lumbar discectomy.In clinical practice
foraminoplasty should be selectively performed according to different types.Type Ⅱ patients do not need foraminoplasty
and type Ⅰ
Ⅲ and Ⅳ patients should choose foraminoplasty.
关键词
极外侧型腰椎间盘突出症经皮椎间孔镜手术临床分型椎间孔成形
Keywords
far laterallumbar disc herniationpercutaneous endoscopic lumbar discectomyclinical classificationforaminoplasty