退行性磁盘变化的影响,在接受全内镜腰椎切除术的患者的早期结果 - - 一项前性研究
Pedro Valente Aguiar1,2, Diogo Bonifácio Afonso1, Paulo Miguel da Silva Pereira1,2
1Faculty of Medicine, University of Porto, Porto, Portugal.
Porto biomedical journal
|December 18, 2025
概括
全内镜腰椎间盘切除术 (FELD) 有效地缓解腰椎间盘 (LDH) 的疼痛. 患有中度退行症 (Pfirrmann等级3) 的患者在FELD后体验到更好的背痛缓解,而不是患有晚期退行症 (Pfirrmann等级4或5) 的患者.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 最少侵入性手术是最少侵入性的手术.
- 退行性椎间盘疾病是一种退行性椎间盘疾病.
背景情况:
- 腰椎间盘 (LDH) 是根茎病和腿部疼痛的常见原因.
- 全内镜腰椎切除术 (FELD) 是LDH的一种微创手术选择.
- 退行性磁盘疾病 (DDD) 对FELD结果的影响尚不清楚.
研究的目的:
- 调查磁盘退化严重程度对LDH的FELD后早期结果的影响.
- 为了比较中度 (Pfirrmann等级<4) 和高级 (Pfirrmann等级4或5) 椎间盘变性患者之间的临床结果.
主要方法:
- 一项针对91名患者进行的前性研究,这些患者接受了LDH的单级FELD.
- 根据Pfirrmann等级,患者被分为两组:<4 (组1) 和4或5 (组2).
- 疼痛 (数值评分表) 和残疾 (奥斯威斯特残疾指数) 被评估为术前和术后.
主要成果:
- 89%的患者患有晚期椎间盘退化 (Pfirrmann 4或5级).
- 第1组 (Pfirrmann 3级) 在手术前背部疼痛较高,但在FELD后背部疼痛明显改善.
- 在奥斯威斯特残疾指数得分或腿部疼痛缓解方面,两组之间没有发现显著差异.
结论:
- 患有中度椎间盘退行症 (Pfirrmann 3级) 的患者报告说,手术前的背部疼痛增加.
- 这些患者在FELD后也经历了优异的背痛缓解,与晚期退化 (Pfirrmann等级4或5) 患者相比.
- 菲尔德在LDH的疼痛管理中表现出有效性,根据退行症的严重程度,不同程度的背痛改善.
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