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AJSM：“内窥镜椎间盘切除术”在治疗运动员腰椎间盘突出症中的应用

2021-10-27 MedSci原创 MedSci原创

经皮经椎间孔内窥镜椎间盘切除术运动员腰椎间盘突出
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腰椎间盘突出症（LDH）是当前临床实践中经常遇到的一种疾病，与普通人群相比，运动员LDH的发生率更高，这是该患者亚类腰痛的常见原因。

腰椎间盘突出症（LDH）是当前临床实践中经常遇到的一种疾病，与普通人群相比，运动员LDH的发生率更高，这是该患者亚类腰痛的常见原因。现在采用内窥镜技术治疗腰椎间盘突出症已经成为一种可行性比较高的选择。

为了研究经皮经椎间孔内窥镜椎间盘切除术（PTED）治疗运动员腰椎间盘突出症的疗效。有55名诊断为腰椎间盘突出症的竞技精英运动员被纳入这项前瞻性研究。所有患者均成功行PTED。临床评估采用完善的下肢和腰痛视觉模拟量表进行。36项简式健康调查（SF-36）用于与健康相关的生活质量分析。术前和术后定期对患者进行评估：6周、3个月、6个月、12个月以及2年。

研究发现手术腰椎水平为L3-L4（5.5%）、L4-L5（69.1%）和L5-S1（25.4%），未观察到重大围手术期并发症。所有患者均在2年时成功完成随访。术后6周，两种视觉模拟量表评分（下肢和腰痛）均显示临床症状显著改善，随后略有改善。所有记录的SF-36参数在6周时均显示出显著的临床改善，在随访结束前有持续的具有统计学意义的显著改善。SF-36的对比评估显示，与休息指数相比，身体功能、身体疼痛、角色情绪和心理健康参数在数量上有更大的改善。

随访期间VAS-LP评分改变。值以中位数(线)和四分位数范围表示

总之，这样研究最终证明了PTED治疗腰椎间盘突出是可行的、有效的技术，在术后疼痛和提高生活质量方面取得了良好的结果。对于L5-S1腰椎间盘突出症的特定病例，这样的手术技术操作可能更具挑战性，外科医生应当充分地评估这些病例是否适合该手术。

参考文献：Kapetanakis S, Gkantsinikoudis N, Charitoudis G. Implementation of Percutaneous Transforaminal Endoscopic Discectomy in Competitive Elite Athletes With Lumbar Disc Herniation: Original Study and Review of the Literature. The American Journal of Sports Medicine. 2021;49(12):3234-3241. doi:10.1177/03635465211032612

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    2022-03-10 lfyang

    #椎间盘突出#

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    2022-06-22 doctorzheng

    #切除术#

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    2021-10-29 anminleiryan

    #腰椎#

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    2021-10-29 紫砂壶

    #内窥镜#

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    2021-10-29 gujh

    #运动员#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1683792, encodeId=d8141683e9247, content=<a href='/topic/show?id=599862899ba' target=_blank style='color:#2F92EE;'>#椎间盘突出#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62899, encryptionId=599862899ba, topicName=椎间盘突出)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=104527995107, createdName=lfyang, createdTime=Thu Mar 10 19:04:06 CST 2022, time=2022-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877499, encodeId=a65618e7499ae, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Jun 22 18:04:06 CST 2022, time=2022-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1272156, encodeId=e13612e21567f, content=<a href='/topic/show?id=cd1a854340b' target=_blank style='color:#2F92EE;'>#腰椎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85434, encryptionId=cd1a854340b, topicName=腰椎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e93e105, createdName=anminleiryan, createdTime=Fri Oct 29 04:04:06 CST 2021, time=2021-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1481590, encodeId=e4b71481590dc, content=<a href='/topic/show?id=0641304e995' target=_blank style='color:#2F92EE;'>#内窥镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30479, encryptionId=0641304e995, topicName=内窥镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db497802700, createdName=紫砂壶, createdTime=Fri Oct 29 04:04:06 CST 2021, time=2021-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604611, encodeId=4ea91604611f0, content=<a href='/topic/show?id=88e6941544c' target=_blank style='color:#2F92EE;'>#运动员#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94154, encryptionId=88e6941544c, topicName=运动员)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0c1419230799, createdName=gujh, createdTime=Fri Oct 29 04:04:06 CST 2021, time=2021-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615428, encodeId=18f8161542865, content=<a href='/topic/show?id=6c6b85465c0' target=_blank style='color:#2F92EE;'>#腰椎间盘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85465, encryptionId=6c6b85465c0, topicName=腰椎间盘)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7c4619628184, createdName=12498974m57暂无昵称, createdTime=Fri Oct 29 04:04:06 CST 2021, time=2021-10-29, status=1, ipAttribution=)]
    2021-10-29 12498974m57暂无昵称

    #腰椎间盘#

    0