手术时间、失血量和X光参数的比较分析：二维导航引导下经皮内窥镜经椎间孔椎间盘切除术与传统显微镜手术治疗腰椎间盘突出症的比较

IF 1.7 4区综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES

Journal of Radiation Research and Applied Sciences Pub Date : 2024-10-14 DOI:10.1016/j.jrras.2024.101142

Weidong Guo , Guifeng Xia , Xin Dong , Xiaoping Zhang , Weiliang Zhang , Bo Liao

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引用次数: 0

摘要

方法回顾性研究了接受二维导航辅助内窥镜（2D-NAE）椎间盘切除术或传统显微手术治疗腰椎间盘突出症（LDH）的患者的临床数据。比较了两组患者的基线特征、围手术期数据、临床结果（包括视觉模拟量表[VAS]评分、Oswestry残疾指数[ODI]评分和改良MacNab标准）和并发症。二维导航组有 47 名患者，而传统显微手术组有 33 名患者。两组患者在每个随访时间点的 VAS 和 ODI 评分均有明显改善（P < 0.05）。围手术期分析显示，二维导航辅助组的手术时间明显更短（42.77 ± 7.56 分钟 vs. 59.33 ± 3.30 分钟；P = 0.01），失血量更少（10.34 ± 2.24 毫升 vs. 11.55 ± 2.20 毫升；P = 0.02）。两组所需的 X 光检查次数相似（2.34 ± 0.48 vs. 2.39 ± 0.56；p = 0.65），术后住院时间相当（p = 0.5）。腿部 VAS 评分和 ODI 评分反映的临床疗效在两组之间无显著差异。结论2D-NAE椎间盘切除术和传统显微镜手术对LDH的治疗效果相当，临床疗效和安全性良好。不过，2D-NAE 手术可能会带来更多益处，包括缩短手术时间、减少失血和减少 X 光检查。

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Comparative analysis of operative time, blood loss, and X-ray parameters: Two-dimensional navigation guided percutaneous endoscopic transforaminal discectomy vs. conventional microscopic surgery for lumbar disc herniation

Purpose

This retrospective comparative study aims to evaluate the clinical efficacy of two-dimensional (2D) navigation-guided percutaneous endoscopic transforaminal discectomy in comparison to conventional microscopic surgery for the treatment of lumbar disc herniation (LDH), based on operative time, blood loss, and X-ray examination parameters.

Methods

Clinical data of patients who underwent either 2D navigation-assisted endoscopic (2D-NAE) discectomy or conventional microscopic surgery for LDH were retrospectively reviewed. Baseline characteristics, perioperative data, clinical outcomes (including visual analog scale [VAS] scores, Oswestry Disability Index [ODI] scores, and Modified MacNab criteria), and complications were compared between the two groups.

Results

A total of 95 patients were included, with 80 having complete follow-up data. The 2D navigation group comprised 47 patients, while the conventional microscopic surgery group had 33 patients. Both groups showed significant improvement in VAS and ODI scores at each follow-up time point (P < 0.05). The perioperative analysis favored the 2D navigation-assisted group, with a significantly shorter operative time (42.77 ± 7.56 vs. 59.33 ± 3.30 min; p < 0.01) and lower blood loss (10.34 ± 2.24 vs. 11.55 ± 2.20 ml; p = 0.02). The number of X-ray examinations required was similar between the two groups (2.34 ± 0.48 vs. 2.39 ± 0.56; p = 0.65), and post-operative hospitalization durations were comparable (p = 0.5). Clinical efficacy, as reflected by VAS scores for legs and ODI scores, showed no significant differences between the groups. Additionally, the Modified MacNab criteria indicated similar rates of excellent and good outcomes.

Conclusion

Both 2D-NAE discectomy and conventional microscopic surgery demonstrated comparable therapeutic outcomes for LDH, with favorable clinical efficacy and safety profiles. However, 2D-NAE surgery may offer additional benefits, including shorter operative times, reduced blood loss, and fewer X-ray examinations.

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来源期刊

Journal of Radiation Research and Applied Sciences MULTIDISCIPLINARY SCIENCES-

自引率

5.90%

发文量

130

审稿时长

16 weeks

期刊介绍： Journal of Radiation Research and Applied Sciences provides a high quality medium for the publication of substantial, original and scientific and technological papers on the development and applications of nuclear, radiation and isotopes in biology, medicine, drugs, biochemistry, microbiology, agriculture, entomology, food technology, chemistry, physics, solid states, engineering, environmental and applied sciences.