关键词: 经皮内镜下椎间孔椎间盘切除术, L₅-S₁, 腰椎间盘突出症, 髂嵴高度, 临床疗效

Abstract:

Objective To investigate the effect of percutaneous endoscopic transforaminal discectomy （PETD） on L₅-S₁ lumbar disc herniation （LDH） and the influence of iliac crest height on the clinical efficacy. Methods A total of 86 patients treated with PETD for LDH （L₅-S₁ segment） from February 2019 to February 2018 were selected and grouped according to the relationship between the highest point of the iliac crest and the position of the L_4-5 pedicle. Forty-eighty patients with the highest point of the iliac crest located below the upper edge of the L₅ pedicle were included in group A； thirty-three patients with the highest point of the iliac crest located between the lower edge of the L₄ pedicle and the upper edge of the L₅ pedicle were included in group B， and five patients with the highest point of the iliac crest located above the lower edge of the L₄ pedicle were included in group C. The operation indexes of the three groups were compared. The visual analogue score （VAS） and Oswestry Disability index （ODI） before and after surgery ［preoperative（T₀）， 1 week after surgery （T₁）， 1 month， 6 months and 12 months after surgery （T₂，T₃，T₄）］were compared among the three groups. Results There was no difference in operation time and blood loss among the three groups （P > 0.05）. At T₀， there was no difference in VAS score and ODI among the three groups （P > 0.05）. At T₁-T₄， when VAS score and ODI of the three groups were lower than that at T₀， VAS in group A and B was lower than that in group C （P < 0.05）， but there was no difference between group A and B （P > 0.05）. Conclusion PETD has significantly clinical efficacy in the treatment of L₅-S₁ LDH， and whether the iliac crest height is higher than the level of the lower edge of the L₄ pedicle will affect its clinical efficacy.

Key words: percutaneous endoscopic transforaminal discectomy, L₅-S₁, lumbar disc herniation, iliac crest height, clinical effect