METHODS: According to the selection criteria, single-segment mild to moderate CDH patients who received LTP-RFA from January 2020 to December 2021 were divided into day surgery procedure (DSP) group and a traditional inpatient procedure (TIP) group. The visual analogue score (VAS) and modified Japanese Orthopedic Association score (mJOA) of neurological function of patients in the two groups were recorded at the time of preoperative, and one day, three months, six months after surgery and the last follow-up respectively. The gender, age, responsible segment, surgical complications, hospitalization time, hospitalization expenses, and patient satisfaction were recorded and analyzed for both groups. The modified Macnab standard was used to evaluate the postoperative efficacy at one month and six months after operation.
RESULTS: A total of 127 patients (75 in DSP;52 in TIP) with complete data were enrolled and completed six month follow-up. There were no statistically significant pre-treatment VAS scores and mJOA scores in the two groups (P>0.05). The postoperative VAS and mJOA scores in both groups were improved after surgery (P<0.05). However, there was no significant difference in VAS scores and mJOA scores between the two groups in the same postoperative period (all P > 0.05). The efficacy of MacNab was similar one month and six months after operation (P > 0.05). The hospitalization time and hospitalization cost were significantly lower in DSP group (all P<0.05). As the treatment effects were comparable, patients in both groups were similarly satisfied at discharge.
CONCLUSIONS: LTP-RFA is an effective method for the treatment of mild to moderate CDH. We suggest that the application of LTP-RFA in DSP for mild to moderate CDH is worthy of wide application.
方法:根据选择标准,从2020年1月至2021年12月接受LTP-RFA的单节段轻度至中度CDH患者被分为日间手术(DSP)组和传统住院手术(TIP)组.术前记录两组患者神经功能视觉模拟评分(VAS)和改良日本骨科协会评分(mJOA),有一天,三个月,分别于术后6个月及末次随访。性别,年龄,负责段,手术并发症,住院时间,住院费用,记录并分析两组患者的满意度.采用改良的Macnab标准评价术后1个月和6个月的疗效。
结果:共纳入127例患者(75例DSP;52例TIP)并完成了6个月的随访。两组治疗前VAS评分和mJOA评分比较,差异无统计学意义(P>0.05)。两组患者术后VAS和mJOA评分均较术后改善(P<0.05)。然而,两组患者术后同期VAS评分和mJOA评分比较差异均无统计学意义(均P>0.05)。MacNab术后1个月和6个月疗效相似(P>0.05)。DSP组住院时间和住院费用明显低于DSP组(均P<0.05)。由于治疗效果相当,两组患者出院时的满意度相似.
结论:LTP-RFA是治疗轻中度CDH的有效方法。我们建议LTP-RFA在DSP中用于轻度至中度CDH的应用值得广泛应用。