内窥镜下环纤维化联合后纵韧带缝合治疗腰椎间盘突出症。

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2024-11-28 DOI:10.1016/j.jor.2024.11.015

Bo He , Minghui Dong , Quan Zhang , Jinhui Bu , Long Xu , Sen Huang , Zhenfei Wang , Xiangbo Bu , Mengzi Hu , Guangpu Liu , Jun Liang , Chao Ma , Guangwang Liu

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引用次数: 0

摘要

目的：探讨全内镜下纤维环与后纵韧带联合缝合技术治疗腰椎间盘突出症的临床可行性、有效性和安全性。方法：回顾性病例对照研究。纳入分析2020年1月至2022年11月在我院治疗的腰椎间盘突出症患者412例。男性208例，女性204例，年龄26 ~ 54岁，平均39.9±5.1岁。经皮腰椎间盘切除术（PELD）术后联合纤维环缝合后纵韧带208例（观察组），单独经皮腰椎间盘切除术（PELD） 204例（对照组）。采用手术时间、出血量、视觉模拟评分（VAS）、Oswestry残疾指数（ODI）、日本骨科协会评分（JOA）、改良MacNab标准及影像学检查进行评价。结果：412例患者均顺利完成手术。完整随访时间12 ~ 18个月，平均15.2±1.6个月。术后症状均明显缓解。各组基线资料比较，差异无统计学意义（P < 0.05）。结论：全内镜下纤维环与后纵韧带联合缝合技术治疗腰椎间盘突出症患者的中短期临床效果满意，可有效降低术后复发率，是一种安全、理想的纤维环破裂缝合技术。临床试验号：不适用。

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A suture technique combining annulus fibrosis with posterior longitudinal ligament for lumbar disc herniation under endoscopy

Purpose

To investigate the clinical feasibility, efficacy and safety of a suture technique combining annulus fibrosus with posterior longitudinal ligament under full endoscopy in patients with lumbar disc herniation.

Methods

Retrospective case-control study. A total of 412 patients with lumbar disc herniation treated in our hospital from January 2020 to November 2022 were enrolled and analyzed. There were 208 males and 204 females, aged from 26 to 54 years old(average 39.9 ± 5.1). 208 patients were treated with combining annulus fibrous suture with posterior longitudinal ligament after percutaneous lumbar discectomy(PELD) (observation group)0.204 patients were treated with percutaneous lumbar discectomy(PELD) alone(control group). Operation time, blood loss, Visual Analogue scale(VAS), Oswestry disability index(ODI),Japanese Orthopedic Association(JOA), modified MacNab criteria and imaging examination were used to evaluate.

Results

All the 412 patients successfully completed the surgery. Complete follow-up time was 12–18 months, with an average of 15.2 ± 1.6 months. Postoperative symptoms were all significantly relieved. There was no statistically significant difference in baseline data between groups (P > 0.05). The scores of VAS,ODI and JOA at different postoperative follow-up visits were significantly lower than those before surgery (P < 0.05). There was significant difference in each group before and after surgeries (P < 0.05). The postoperative recurrence rates and reoperation rates between groups were significant different(P < 0.05). According to MacNab, the excellent and good rate was 96.2 % (200/208) in observation group and 90.7 % (185/204) in control group(P < 0.05).

Conclusions

The suture technique combining annulus fibrosus with posterior longitudinal ligament under full endoscopy in patients with lumbar disc herniation has satisfactory short- and mid-term clinical effect,and can effectively reduce postoperative recurrence rate, which is a safe and ideal suture technique for annulus fibrosus rupture.

Clinical trial number

not applicable.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.