Destandau技术治疗腰椎间盘突出症的临床评价

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-09-18 DOI:10.1016/j.jcot.2025.103210

Amarkant Thakur, Vedpal Yadav, Pankaj Kumar

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引用次数: 0

摘要

背景：评价应用Destandau's技术进行椎板间内窥镜椎间盘切除术治疗症状性腰椎间盘突出症的临床效果，重点关注功能改善、疼痛缓解和患者总体满意度。材料和方法本前瞻性观察性研究在某三级医院骨科进行。所有病例均采用Destandau技术进行椎板间内窥镜腰椎间盘切除术，这是一种微创手术，涉及脊柱内系统进入并减压受影响的神经根。共有15例患者，年龄在18至60岁之间，有症状的腰椎间盘突出症，对至少6周的保守治疗难以治愈。术前评估包括临床和神经学评估以及标准化的结果测量，包括Oswestry残疾指数（ODI）、疼痛视觉模拟量表（VAS）和Macnab结果评分。术后护理包括适当的镇痛，早期活动，并在2周，6周和3个月进行随访，以监测恢复情况并评估结果。结果参与者平均年龄36.47±8.33岁，男性占66.7%。L5-S1是最常见的受累节段（53.3%）。ODI和VAS评分在2周、6周和3个月时均有显著改善（p < 0.001）。根据McNab的标准，26.7%的患者获得了优异的结果，53.3%的患者获得了良好的结果，20%的患者获得了一般的结果。并发症发生率低，住院时间短，86.7%的患者在2天内出院。结论采用Destandau技术的内窥镜椎间盘切除术可显著降低疼痛和残疾评分，并在3个月的随访期间获得良好的功能结果。这些发现支持其在手术治疗症状性腰椎间盘突出症中的有效性。

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Clinical evaluation of interlaminar endoscopic discectomy in lumbar disc herniation by Destandau's technique

Background

To evaluate the clinical outcomes of interlaminar endoscopic discectomy using Destandau's technique in patients with symptomatic lumbar disc herniation, focusing on functional improvement, pain relief, and overall patient satisfaction.

Materials and methods

This prospective observational study was conducted in the Department of Orthopaedic Surgery at a tertiary care hospital. Surgical intervention in all cases was performed using Destandau's technique for interlaminar endoscopic lumbar discectomy, a minimally invasive procedure involving an endospine system to access and decompress the affected nerve root.

A total of 15 patients aged between 18 and 60 years with symptomatic lumbar disc herniation refractory to at least six weeks of conservative treatment were included. Preoperative assessment comprised clinical and neurological evaluation and standardised outcome measures, including the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for pain, and the Macnab Outcome Score.

Postoperative care included appropriate analgesia, early mobilisation, and scheduled follow-up visits at 2 weeks, 6 weeks, and 3 months to monitor recovery and assess outcomes.

Results

The mean age of participants was 36.47 ± 8.33 years, with a male predominance (66.7 %). L5-S1 was the most commonly affected level (53.3 %). ODI and VAS scores showed significant improvement at 2 weeks, 6 weeks, and 3 months (p < 0.001). According to McNab's criteria, 26.7 % achieved excellent outcomes, 53.3 % good, and 20 % fair. Complication rates were minimal, and hospital stays were brief, with 86.7 % discharged within 2 days.

Conclusion

Endoscopic discectomy using the Destandau technique significantly reduced pain and disability scores, along with favourable functional outcomes over a 3-month follow-up period. These findings support its effectiveness in the surgical management of symptomatic lumbar disc herniation.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.