| 椎间孔镜术后副损伤导致腰臀部疼痛原因分析 |
| 投稿时间：2018-01-04 修订日期：2018-01-22 点此下载全文 |
| 引用本文：甄瑞鑫,刘士波,曹雪峰,张忠岩,马桂云,陈宾.椎间孔镜术后副损伤导致腰臀部疼痛原因分析[J].医学研究杂志,2018,47(11):146-150 |
| DOI：
10.11969/j.issn.1673-548X.2018.11.032 |
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| 中文摘要:目的 对实施经椎间孔脊柱内镜手术后副损伤分析，以期对临床工作提供参考。方法 通过纳入标准、手术标准筛选患者。术后1个月、6个月时进行腰椎稳定性评价，并按术后复查时是否接受逐层阻滞，将患者分为阻滞组与非阻滞组。通过术前1天、术后1周、1.5个月、3个月、6个月患者的腰痛及下肢VAS及ODI评分，并进行统计分析。结果 共68例，男性42例，女性27例，年龄28~53岁，平均年龄38岁，其中腰3/4节段3例，腰4/5节段41例，腰5/骶1节段24例。其中阻滞组43例，非阻滞组25例。术后1个月68例患者无腰椎不稳表现；阻滞组阻滞有效部位集中于椎小关节、纤维环，全部68例患者术前，术后6个月VAS、ODI评分配对t检验，差异有统计学意义（P=0.000）。术后各随访时间点组间独立样本t检验，差异无统计学意义（P>0.05）。结论 实施经椎间孔脊柱内镜技术后，椎小关节囊、纤维环的损伤是引发腰臀部疼痛的参与因素， 但疼痛程度不影响腰椎功能的恢复。 |
| 中文关键词:内镜 手术创伤 腰痛 椎小关节囊 局部阻滞 |
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| Cause Analysis of Lower Back and Hip Pain Caused by Secondary Injury after the Transforaminal Spinal Endoscopic Surgery |
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| Abstract:Objective Analyze the secondary injury after the transforaminal spinal endoscopic surgery so as to provide reference for clinical work. Methods Screen patients by inclusion criteria and surgical criteria. Evaluate the stability of lumbar spine at 1 and 6 months after surgery, and divide patients into 2 groups: block group and non-block group according to whether or not to accept block-by-layer on post-operative review. Make statistical analysis of lumbar pain 1 day before surgery, 1 week, 1.5 months, 3 months and 6 months after surgery and lower limb VAS and ODI scores. Results There are 68 patients (males 42 and females 26), aged from 28 to 53 (with an average of 38), among whom L3/4 3 cases,L4/5 41 cases,L5/S1 24 cases, and block 43 cases, non-block 25 cases. All patients show no lumbar instability 1 months after surgery. The effective parts of the block are mainly located in facet joint of lumbar and the fiber ring. All 68 patients, before surgery and 6 months after surgery, were paired with t test for VAS and ODI score; with P=0.000, the difference is statistically significant. T test of independent sample from each follow-up time group after operation, P>0.05, the difference is not statistically significant. Conclusion After the transforaminal spinal endoscopic surgery, the injury of the facet joint capsule and fiber ring is a contributing factor to the pain in the low back and hip, but the degree of pain does not affect the recovery of lumbar function. |
| keywords:Endoscope Operation injury Low back pain Facet joint capsule Local block |
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