椎间盘水平 - - 针对腰椎椎间盘的内性孔多利酶注射的特定结果:一项多中心回顾性研究
Kota Watanabe1, Yohei Takahashi2, Takehiro Michikawa3
1Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.
概括
内孔多利酶注射对腰椎间盘 (LDH) 显示出一致的疗效,特别是在腰部上部水平. 这种微创治疗为手术提供了一种安全的替代方案,结果因磁盘水平而异.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 最少侵入性手术的方法
背景情况:
- 腰椎间盘 (LDH) 治疗疗效可能因椎间盘水平而异.
- 腰椎上部带由于解剖学的限制而存在独特的挑战.
- 内孔道酶注射的磁盘水平特异性结果仍未得到充分研究.
研究的目的:
- 为了评估LDH在不同腰椎盘水平的内垂体孔多利酶注射的有效性.
- 为了比较孔多利酶结局与微内科切除术 (MED) 结局.
- 为了确定康多利酶的疗效是否在上腰椎和下腰椎之间有所不同.
主要方法:
- 在262名患有LDH的患者中进行了多中心回顾性队列研究.
- 内孔多酶注射 (CD组,n=207) 和MED (n=55) 之间的比较.
- 根据的水平分层的患者:腰部上部 (L1/2-L3/4) 和腰部下部 (L4/5,L5/S1).
- 主要结局:腿部/背部疼痛1年后的NRS得分,响应率,重新手术率.
主要成果:
- 在所有磁盘水平上,Condoliase表现出一致的疗效,在腰部上部水平 (L1/2-L3/4) 取得了优异的结果.
- 在L3/4时,孔多酶的响应率比MED (57.1%) 高 (100%).
- 在L4/5,MED提供了更大的腿部疼痛缓解和更高的响应率比condoliase,虽然condoliase显示稳步改善.
- 腰部疼痛的改善是适度的,在不同组和水平之间是可比的.
结论:
- 内孔多利酶注射是有效的,特别有利于腰部上部LDH.
- Condoliase提供了一种安全的,最少侵入性的替代方案,用于上腰椎间盘.
- 康多利和手术之间的治疗选择应以受影响的特定磁盘水平为指导.
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