PDF(Pubmed)
Abstract：
BACKGROUND: Percutaneous Endoscopic Lumbar Discectomy (PELD) has emerged as routine treatment for lumbar disc herniation (LDH) due to its minimal invasiveness and quick recovery. However, PELD demands high precision from the surgeon, as the risk of intraoperative complications is substantial, including potential damage to the nerve root and dura, and a higher likelihood of recurrence post-surgery. Thus, preoperative planning utilizing CT and MRI imaging is essential.
METHODS: In this study, the clinical data of 140 patients treated with PELD for LDH from January 2021 to December 2023 were retrospectively analyzed. Patients were categorized into two groups based on whether CT and MRI registration (CMR) was employed for surgical planning: a CMR group (n=68) and a control group (n=72). Data collected included surgery time, hospital stay duration, and scores from the Visual Analog Scale (VAS) for low back and leg pain, as well as the Japanese Orthopaedic Association Lumbar Spine Score (JOA). Differences between the two groups were assessed using the Student\'s t-test.
RESULTS: No significant difference was found in hospital stay length between the groups (P=0.277). Surgery time was significantly shorter in the CMR group (P<0.001). Prior to surgery, no significant differences in VAS scores for leg and low back pain were observed between the groups (P=0.341 and P=0.131, respectively); however, at 2 months postoperatively, both scores were significantly lower in the CMR group (P<0.001 and P=0.002, respectively). Similarly, no difference in preoperative JOA scores was noted (P=0.750), but at 2 months postoperative, the CMR group exhibited significantly higher scores (P<0.001).
CONCLUSIONS: Compared with the traditional PELD, the preoperative use of CMR has shown to reduce surgery time, alleviate leg and low back pain, and increase the lumbar JOA score at 2 months after surgery, underscoring its efficacy in enhancing surgical outcomes.
METHODS: In this study, the clinical data of 140 patients treated with PELD for LDH from January 2021 to December 2023 were retrospectively analyzed. Patients were categorized into two groups based on whether CT and MRI registration (CMR) was employed for surgical planning: a CMR group (n=68) and a control group (n=72). Data collected included surgery time, hospital stay duration, and scores from the Visual Analog Scale (VAS) for low back and leg pain, as well as the Japanese Orthopaedic Association Lumbar Spine Score (JOA). Differences between the two groups were assessed using the Student\'s t-test.
RESULTS: No significant difference was found in hospital stay length between the groups (P=0.277). Surgery time was significantly shorter in the CMR group (P<0.001). Prior to surgery, no significant differences in VAS scores for leg and low back pain were observed between the groups (P=0.341 and P=0.131, respectively); however, at 2 months postoperatively, both scores were significantly lower in the CMR group (P<0.001 and P=0.002, respectively). Similarly, no difference in preoperative JOA scores was noted (P=0.750), but at 2 months postoperative, the CMR group exhibited significantly higher scores (P<0.001).
CONCLUSIONS: Compared with the traditional PELD, the preoperative use of CMR has shown to reduce surgery time, alleviate leg and low back pain, and increase the lumbar JOA score at 2 months after surgery, underscoring its efficacy in enhancing surgical outcomes.
摘要：
背景：经皮内窥镜腰椎间盘切除术（PELD）由于其微创和快速恢复，已成为腰椎间盘突出症（LDH）的常规治疗方法。然而,PELD需要外科医生的高精度，由于术中并发症的风险很大，包括对神经根和硬脑膜的潜在损害，手术后复发的可能性更高。因此，术前计划利用CT和MRI成像至关重要.
方法：在本研究中，回顾性分析2021年1月至2023年12月140例接受PELD治疗的LDH患者的临床资料.根据是否采用CT和MRI配准（CMR）进行手术计划，将患者分为两组：CMR组（n=68）和对照组（n=72）。收集的数据包括手术时间，住院时间,和下腰和腿部疼痛的视觉模拟量表（VAS）评分，以及日本骨科协会腰椎评分（JOA）。使用Studentt检验评估两组之间的差异。
结果：两组间住院时间无显著差异（P=0.277）。CMR组手术时间明显缩短(P<0.001)。手术前,两组之间的腿部疼痛和下腰痛的VAS评分没有显着差异（分别为P=0.341和P=0.131）；然而，术后2个月，CMR组的两项评分均显著降低(分别为P<0.001和P=0.002).同样，术前JOA评分无差异(P=0.750),但术后2个月,CMR组的评分明显较高(P<0.001).
结论：与传统PELD相比，术前使用CMR已显示出减少手术时间，缓解腿部和腰痛，术后2个月增加腰椎JOA评分,强调其在提高手术效果方面的功效。
方法：在本研究中，回顾性分析2021年1月至2023年12月140例接受PELD治疗的LDH患者的临床资料.根据是否采用CT和MRI配准（CMR）进行手术计划，将患者分为两组：CMR组（n=68）和对照组（n=72）。收集的数据包括手术时间，住院时间,和下腰和腿部疼痛的视觉模拟量表（VAS）评分，以及日本骨科协会腰椎评分（JOA）。使用Studentt检验评估两组之间的差异。
结果：两组间住院时间无显著差异（P=0.277）。CMR组手术时间明显缩短(P<0.001)。手术前,两组之间的腿部疼痛和下腰痛的VAS评分没有显着差异（分别为P=0.341和P=0.131）；然而，术后2个月，CMR组的两项评分均显著降低(分别为P<0.001和P=0.002).同样，术前JOA评分无差异(P=0.750),但术后2个月,CMR组的评分明显较高(P<0.001).
结论：与传统PELD相比，术前使用CMR已显示出减少手术时间，缓解腿部和腰痛，术后2个月增加腰椎JOA评分,强调其在提高手术效果方面的功效。
