实用医学杂志 ›› 2021, Vol. 37 ›› Issue (21): 2733-2738.doi: 10.3969/j.issn.1006⁃5725.2021.21.006

• 临床研究 • 上一篇    下一篇

电磁导航与C臂透视引导经皮椎间孔镜手术治疗腰椎间盘突出症的疗效比较:2年随访

林涌鹏1,2 李永津1,2 陈博来1,2 赵帅1,2 饶思远1 林锐1 胡伟雄2 王洪伸2 温涛2   

  1. 1 广州中医药大学第二临床医学院(广州 510120);2 广州中医药大学第二附属医院(广州 510120)

  • 出版日期:2021-11-10 发布日期:2021-11-10
  • 通讯作者: 陈博来 E⁃mail:chenbolai@gzucm.edu.cn
  • 基金资助:
    国家自然科学基金(编号:82004385);广东省自然科学基金(编号:2019A1515011916);广州中医药大学一流学科/高水平大学建设项目(编号:A3⁃0402⁃20⁃415⁃049)

Comparison of the efficacy of electromagnetic navigation and C ⁃ arm fluoroscopy guided percutaneous endoscopic transforaminal discectomy in the treatment of lumbar disc herniation:Study with a 2⁃year follow⁃up 

LIN Yongpeng*,LI Yongjin,CHEN Bolai,ZHAO Shuai,RAO Siyuan,LIN Rui,HU Weixiong,WANG Hongshen WEN Tao.    

  1. The Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510120 China;*The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China

  • Online:2021-11-10 Published:2021-11-10
  • Contact: CHEN Bolai E⁃mail:chenbolai@gzucm.edu.cn

摘要:

目的 对比分析电磁导航引导经皮椎间孔镜下腰椎间盘切除术(see electromagnetic⁃naviga⁃ tion endoscopic spinal surgery system,SEESSYS)与C臂透视引导经皮椎间孔镜下腰椎间盘切除术(transforam⁃ inal endoscopic surgical system,TESSYS)的疗效,探讨电磁导航技术在椎间孔镜手术应用中的优势与不足。 方法 2018 9-12 月在我院接受经皮椎间孔镜手术治疗的 44 例腰椎间盘突出症患者,SEESSYS 组和 TESSYS 组各 22 例。比较两组的手术时间(置管时间与镜下减压时间)、术中透视次数、住院天数。应用视 觉模拟量表(VAS)评分、Oswestry 残疾指数(ODI)和改良MacNab 标准进行疗效评估。结果 SEESSYS 组的 置管时间、总手术时间和术中透视次数均明显短于TESSYS组(P < 0.01),而两组的镜下减压时间和住院天 数差异无统计学意义(P > 0.05)。SEESSYS 组和 TESSYS 组的术后 ODI VAS 明显低于术前(P < 0.01),但 两组之间各时间点的 ODI VAS 评分差异无统计学意义(P > 0.05)。2 年随访后,SEESSYS 组的优良率是 95.5%,TESSYS 组为 90.91%。结论 相对于 C 臂透视引导,电磁导航经皮椎间孔镜手术 2 年随访的临床疗 效明确,有助于减少术中X线辐射损害,也能有效缩短置管时间和总体手术时间,提高手术效率。

关键词: 电磁导航,  , 脊柱内镜,  , 椎间盘切除术,  , 腰椎间盘突出症

Abstract:

Objective To compare the clinicalefficacy of electromagnetic⁃navigation guided transforaminal endoscopic spinal discectomy(See electromagnetic⁃navigation endoscopic spinal surgery system,SEESSYS)and C⁃arm fluoroscopy guided transforaminal endoscopic spinal discectomy(Transforaminal endoscopic surgical systemTESSYS)in the treatment of lumbar disc herniation. In addition,the use of electromagnetic navigation technology in the application of percutaneous endoscopic lumbar discectomy will be discussed for its safety and benefits. Methods From September to December 2018,a retrospective analysis was performed on 44 cases of LDH patients who had surgical therapy in our hospital. According to the varied surgical procedures,they were classified into two groups:SEESSYS and TESSYS,with 22 cases in each group. The two groups were compared on perioperative indi⁃ cators such as operation time(working tube placement time and endoscopic decompression time),intraoperative fluoroscopy timings,and length of hospital stay. The surgical complications were also recorded. Results The work⁃ ing tube placement time,total operation time and the number of intraoperative C⁃arm fluoroscopy of the SEESSYS group were significantly shorter than those of the TESSYS group(P < 0.01),however,there were no significant difference in the time of endoscopic decompression and the length of hospital stay between the two groups(P > 0.05). The postoperative ODI,back and leg VAS were significantly lower than those of pre⁃operation in both groups(P < 0.01),but there was no significant difference in the VAS and ODI scores between the two groups(P > 0.05). At the 2⁃year follow⁃up,the excellent and good rate of SEESSYS group was 95.5%,and TESSYS group was 90.91%.Conclusions At a 2⁃year follow⁃up,the SEESSSYS has a satisfactory clinical effect when compared to traditional C ⁃ arm fluoroscopy guidance. Furthermore,electromagnetic navigation aids in reducing radiation exposure to medical personnel during the procedure,as well as effectively shortening the working tube placement and the over⁃ all operation time.

Key words:

electromagnetic ? navigation guidance, spinal endoscopic surgery, lumbar discectomy, lumbar disc herniation