十年来经皮腰椎手术后使用减压器的手术频率。

IF 1.3 Q3 SURGERY
Minimally Invasive Surgery Pub Date : 2018-10-09 eCollection Date: 2018-01-01 DOI:10.1155/2018/5286760
Stephan Klessinger
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引用次数: 4

摘要

为了防止开放性手术,微创技术,如减压器(PLDD)已经被开发出来。无再疝是腰椎手术后临床成功的重要因素。在这项回顾性观察性研究中,我们对长时间回顾性PLDD后进行额外开放手术的频率进行了研究。评估临床症状与预后的相关性,并分析PLDD与开放手术之间的时间。纳入了2005 - 2007年间连续接受PLDD治疗的患者。采用MacNab结局标准评价患者满意度。分析腰椎额外开放手术的需要、减压术和手术之间的时间以及治疗水平。本研究共纳入73例患者。患者于PLDD后1个月就诊。大多数患者(76.7%)有额外的神经根痛。最常见的是L4-5节段(58.9%)。随访时间超过5年的占30.1%,随访时间超过10年的占6.82%。短期成功率为67.1%。26.0%的患者接受了额外的手术,78.9%的患者在PLDD后的第一年进行了再手术。这些患者的预后差有统计学意义(P = 0.025)。所有早期后续手术患者均存在神经根疼痛,但只有50%的晚期手术患者存在神经根疼痛(P = 0.035)。疼痛缓解不良的患者出现神经根疼痛的比例明显高于对照组(P = 0.04)。短期成功率因26.0%的手术率而恶化。PLDD后短时间内的后续手术提示PLDD不能替代开放椎间盘切除术。由于神经根疼痛患者预后较差,手术次数较多,神经根疼痛是否是PLDD的理想指征还有待讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Frequency of Resurgery after Percutaneous Lumbar Surgery Using Dekompressor in a Ten-Year Period.

The Frequency of Resurgery after Percutaneous Lumbar Surgery Using Dekompressor in a Ten-Year Period.

To prevent open surgical procedures, minimally invasive techniques, like Dekompressor (PLDD), have been developed. The absence of reherniation is an important factor correlating with clinical success after lumbar surgery. In this retrospective, observational study, the frequency of additional open surgery after PLDD in a long time retrospective was examined. The correlation between clinical symptoms and outcome was assessed, and the time between PLDD and open surgery was analyzed. Consecutive patients after PLDD between 2005 and 2007 were included. MacNab's outcome criteria were used to evaluate patient satisfaction. The need for additional open surgery of the lumbar spine, the period between Dekompressor and resurgery, and the treated levels were analyzed. In total, 73 patients were included in this study. The patients were seen one month after PLDD. The majority of patients (76.7%) had additional radicular pain. The most common level treated was L4-5 (58.9%). The follow-up time was longer than 5 years in 30.1% of the patients and longer than 10 years in 6.82%. The short-term success rate was 67.1%. Additional surgery was performed in 26.0% of patients, with 78.9% of the reoperations undertaken during the first year after PLDD. These patients had a statistically significant worse outcome (P = 0.025). Radicular pain was present in all patients with an early subsequent surgery, but only in 50% of patients with late surgery (P = 0.035). Significantly more patients with poor pain relief had radicular pain (P = 0.04). The short-term success rate was worsened by a resurgery rate of 26.0%. Subsequent surgery, a short time after PLDD, suggests that PLDD is not a replacement for open discectomy. Because patients with radicular pain had a worse outcome and more frequent resurgeries, whether radicular pain is an ideal indication for PLDD should be discussed.

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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
8
审稿时长
16 weeks
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