椎间孔镜YESS与TESSYS技术治疗腰椎间盘突出症

被引：429

作者：

周跃

李长青

王建

张正丰

初同伟

潘勇

郑文杰

罗刚

机构：

[1] 第三军医大学附属新桥医院骨科

来源：

中华骨科杂志 | 2010年 / 03期

关键词：

椎间盘移位; 内窥镜; 腰椎;

D O I：

暂无

中图分类号：

R687.3 [骨骼手术];

学科分类号：

100220 [骨科学];

摘要：

目的探讨椎间孔镜YESS(Yeung endoscopic spine system)和TESSYS(transforaminal endoscopicspine system)技术治疗腰椎间盘突出症的适应证、手术技巧及临床效果。方法 2005年9月至2008年5月,201例腰椎间盘突出症患者分别采用YESS(150例)和TESSYS(51例)椎间孔镜手术治疗。男122例,女79例;年龄17～79岁,平均33.5岁。疗效评定依据疼痛视觉模拟评分(visual analoguescore,VAS)和Nakai分级法。结果 162例(80.6%)获得随访,YESS手术组119例(79.3%)、TESSYS手术组43例(84.3%)。随访3～36个月,平均12.5个月。YESS手术组术前腿痛VAS评分(8.4±2.1)分,术后1年(2.4±0.8)分,差异有统计学意义;TESSYS手术组术前腿痛VAS评分(8.6±2.3)分,术后1年(2.6±1.3)分,差异有统计学意义。YESS手术组优良率87.5%,TESSYS手术组88.4%。两组均无永久性神经根损伤、大血管损伤和硬脊膜囊撕裂等并发症。YESS手术组6例术后无效,4例术后复发者行翻修术;TESSYS手术组1例术后无效,2例术后复发者行翻修术。结论椎间孔镜手术治疗腰椎间盘突出症安全、有效。根据不同类型和不同部位,正确选择YESS技术或TESSYS技术是手术成功的关键。

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