单层腰椎间盘突出症患者的内窥镜与显微镜椎间盘切除术

Zia-Ur- Rehman, Muhammad Ibrahim
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摘要

目的:在一项随机对照试验中,比较了内窥镜椎间盘切除术和显微椎间盘切除术治疗腰椎间盘疾病的效果。材料与方法:这项随机对照实验研究于 2021 年 1 月至 2022 年 1 月在吉尔吉斯坦三级医院进行。研究对象包括 40 名腰部不适并向下传至腿部的患者,磁共振成像(MRI)显示他们患有 L5-S1 和 L4-L5 水平的椎间盘突出。他们的年龄从 12 岁到 64 岁不等。患者在全身麻醉下仰卧,在透视引导下进行内窥镜/显微镜椎间盘切除术。所有患者在手术后都在恢复室接受了两个小时的监护,然后才被转移到病房。使用奥斯韦特里残疾指数(ODI)对所有患者进行为期一年的临床随访。结果男性患者有 22 人(55%),女性患者有 18 人(45%),年龄从 12 岁到 64 岁不等。患者平均年龄为 52.5 岁。分别有 13 名(32.5%)和 27 名(67.5%)患者的椎间盘脱出位于 L4-L5 和 L5-S1。内窥镜椎间盘切除术组和显微镜椎间盘切除术组患者术后的模拟视觉评分均有明显改善。尽管如此,与显微镜下椎间盘切除术组相比,内窥镜下椎间盘切除术组术后所需止痛药量更少,住院时间更短,活动更快。结论内窥镜椎间盘切除术和显微椎间盘切除术都是安全且同样有效的手术。它们都能缓解疼痛。然而,内窥镜椎间盘切除术的优点是可早期活动,术后不适感减少。关键词内窥镜椎间盘切除术 显微镜椎间盘切除术 腰椎间盘突出症 脊柱手术 微创手术
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Endoscopic Vs. Microscopic Discectomy for Single Level Lumber Prolaps Disc Patients
Objective: An endoscopic discectomy and a microdiscectomy for lumbar spine disc disease were compared in a randomized controlled trial. Material and Methods: This randomized controlled experiment study conducted at the tertiary care hospital of KPK from Jan 2021 to Jan 2022. The study comprised 40 patients suffering from low back discomfort that travels down their legs and who have prolapsed intervertebral discs at the L5-S1 and L4-L5 levels, as shown on magnetic resonance imaging (MRI). They varied in age from 12 to 64. Endoscopic/microscopic discectomy with fluoroscopic guidance was conducted while the patient was laying on his or her back under a general anesthetic. All patients were monitored who spending two hours in the recovery room after surgery before being transferred to the ward. All patients were clinically followed up for a year using the Oswestry disability index (ODI). Results: There were 22(55%) male patients and 18(45%) female patients, ranging in age from 12 to 64. On average, the patients were 52.5 years old. Thirteen (32.5%) and 27(67.5%) patients had prolapsed discs at the L4-L5 and L5-S1 levels. Patients in the endoscopic and microscopic discectomy groups both improved significantly in their analog visual ratings after surgery. Despite this, A less amount of postoperative pain medication was needed, a shorter length of stay in the hospital, and quicker mobility for the endoscopic discectomy group compared to the microscopic group. Conclusion: Both endoscopic and microdiscectomy are safe and equally effective procedures. Each of them is capable of relieving. Nonetheless, early mobility and decreased postoperative discomfort were advantages of the endoscopic discectomy. Keywords: Endoscopic Discectomy, Microscopic Discectomy, Lumbar Prolapse Disc, spinal surgery, Minimally invasive surgery
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