脊柱内镜与椎间融合治疗腰椎间盘突出症伴终板骨软骨炎的疗效对比

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Abstract Objective To compare the effects of spinal endoscopy and lumbar interbody fusion in treatment of lumbar intervertebral disc herniation associated with endplate osteochondritis.Methods A retrospective analysis was performed on 116 cases of patients with lumbar intervertebral disc herniation associated with endplate osteochondritis.They underwent surgery in our department from March 2015 to February 2017 and were followed up for more than 1 year.The patients had an average age of 42.7 years old(range from 33 to 69 years old).According to the treatment，they were divided into two groups.27 cases were treated with percutaneous intervertebral endoscopic surgery(35 males and 20 females).There were 3 cases of L_3～4，27 cases of L_4～5 and 25 cases of L₅S₁.Removal of herniated nucleus pulposus and nerve root decompression and release were performed on the side with severe clinical symptoms.Another 61 cases(31 cases were males and 30 were females) were treated with interbody fusion surgery，including L_3～4 in 5 cases，L_4～5in 29 cases and L₅S₁ in 27 cases.Laminar decompression was performed on the responsible intervertebral segment to remove the intervertebral disc tissue，and interbody fusion with bone graft to provide a firm pedicle screw fixation.The operation time，length of surgical incision，volume of blood loss，length of stay were compared between two groups.During the follow-up，the Visual analogue scale(VAS) and Oswestry disability index(ODI) were observed.Excellent rate was evaluated according to the MacNab criteria.Results All patients were received successful treatment and followed up with a mean follow-up of 17.8 months(range 12 to 24 months).The operation time，length of surgical incision，volume of blood loss，length of stay in spinal endoscopy group were better than those in lumbar interbody fusion group(P＜0.05).Compared with pre-operation，the VAS and ODI scores were decreased in the first，6th month，and final follow-up after operation in two groups(P＜0.05).However，no significant difference was observed between spinal endoscopy group and lumbar interbody fusion group(P＞0.05).There was no statistical difference in the effective rates between spinal endoscopy group(92.7%) and lumbar interbody fusion group(88.5%)(P＞0.05).Conclusion Spinal endoscopy and interbody fusion repair can achieve good effect in the treatment of lumbar intervertebral disc herniation associated with end-plate osteochondritis，and there is no statistical difference in effect between these two groups.However，spinal endoscopic surgery has advantages of minimal trauma，short hospitalization time and quick recovery.

Key words： lumbar disc herniation end-plate osteochondritis lumbar fusion endoscopic

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[1]	. [J]. sygkzz, 2021, 27(1): 66-87.