关键词:

经皮椎间孔镜技术, 巨大型, 腰椎间盘突出症, 腰椎功能, 脊髓功能, 创伤程度

Abstract: Objective To investigate the effect of percutaneous endoscopic lumbar discectomy（PELD） on the functional recovery and trauma of patients with large lumbar disc herniation（LLDH）. Methods A total of 92 LLDH patients in our hospital from June 2017 to July 2019 were selected for a prospective study. They were divided into observation group（n = 46）and control group（n = 46）according to a random number table. The control group underwent posterior lumbar interbody fusion（PLIF），and the observation group was treated with PELD technology. The operation conditions，complications，and serum trauma index［C⁃reactive protein（CRP），inter⁃ leukin⁃6（IL⁃6），β⁃endorphin（β⁃EP），prostaglandin E2（PGE2）］levels before and 1 d and 3 d after the opera⁃ tion，spinal cord function indexes（the incubation period of the tibial nerve and the common peroneal nerve，nerve conduction velocity）before operation，1 month and 3 months after operation were compared between the two groups. The postoperative follow⁃up was 1 year，and the curative effects and the Oswestry dysfunction index（ODI） and visual analog pain score（VAS）before operation，6 months and 12 months after operation of the two groups were calculated. Results The radiation exposure of the observation group was higher than that of the control group， but the operation time and hospital stay were shorter than those of the control group，and the intraoperative blood loss was lower than that of the control group（P < 0.05）. There was no significant difference in the incidence of complications between the two groups（P > 0.05）；serum CRP，IL⁃6，β⁃EP，and PGE2 levels in the observation group were lower than those in the control group at 1 and 3 days after surgery（P < 0.05）. The latency of the tibial nerve and common peroneal nerve in the observation group was lower than that of the control group at 1 and 3 months after operation，and the nerve conduction velocity was higher than that of the control group（P＜0.05）The ODI and VAS scores of the observation group at 6 months and 1 year after operation were lower than those of the control group（P < 0.05）；there was no significant difference in the excellent and good rate of operation 1 year after operation in the two groups（P > 0.05）. Conclusion PELD technology can achieve surgical results equivalent to PLIF in the treatment of LLDH patients，and has the advantages of less trauma，short operation time，and quick postoperative recovery. Moreover，it has the advantages of less trauma，short operation time，and quicker recovery after surgery. It can reduce traumatic stress，and more effectively improve the symptoms of low back pain，spinal cord function，and lumbar function，but the radiation exposure is increased.

Key words:

percutaneous endoscopic lumbar discectomy, giant type, lumbar disc herniation, lumbar spine function, spinal cord function, degree of trauma