经皮椎间孔镜靶向穿刺技术治疗腰椎间盘突出症的近期疗效观察

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1、ThetherapeuticeffectanaIysisofthepercutaneoustransforaminalendoscopicdiscectomy—TARGETtechniques—forIumbardischerniationSpeciaIity：0rthopedicsofTCMAuthor：GuWeiwenSuperVisor：XuFengABSTRACT0bjective：aimofourstudyistoevaluatethesecurityandeffectivenessoftarget

2、edpercutaneoustransforaminalendoscopicdiscectomy(PTED)intreatinglumbardischerniation．Methods：Weretrospectivelyexamined60patientswithsin91esegmentlumbardischerniationwhoweresufferedfromseVerebackandlegpain，definitelydiagnosedbyComputedTomography(CT)andandJ．e

3、gpaln，detlnlteJ．ydlagnOsedby乙OmputeQ10mograpnyk乙lJaIlQMagneticResonanceImaging(MRI)．ThepatientswhoweretreatedwithPTEDintheperiodfromAugust，2011toAugust，2012，including32malesand28females，agedfrom17to70years01d(aVeraged35．0years)．Afterlocalanesthesia，wepunctu

4、retheentrypointandgraduallyexpandtotheinterVertebralforamenundertheguidanceofX—rav．Intheviewofendoscopic，weexcisethepulpiformnucleusprecisely．TheclinicaloutcomeswereevaluatedbyVisualanaloguescale(VAS)，oswestrydisabilityindex(0DI)andmodifiedMacnabcriteriabef

5、oreandafteroperationoratthefinalfollowup．ResuIts：Inthegroupof60patients，Onepatientunabletot01eratelocalanesthesiaduringsurgeryandOnepatientbecausetheguidewirefractureduringpuncturehavingreceiVedthemicro—endoseopicdiscectomy(M[ED)，noonehaVingreceiVedtheopeno

6、peration．58一patientswentthroughtheoperationsuccessfully，NoⅢsurgicalcomplicationsoccurred．Theelapsedtimeofsurgerywas28to90minutes(mean55．6minutes)；andthebleedingontheoperationsrangedfrom10to30ml(mean18．Om1)．Weobtainedtheresultbelowthrough6to18months(mean12．5

7、months)follow—up，and14patientsamongthembeinglostafter6months．ComparedwiththeVASscoringbeforetheoperation，thescoresofbackand1egpainaftertheoperationweresignificantlydecreased(P<0．01)．ODIbeforeand6monthsafteroperationwere66．46％and19．66％respectiVely．Thereweres

8、ignificantdifferencescomDaredwithpreoperatiVescore(P