Volume 22 Issue 11
Nov.  2024
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TAN Fang, ZHANG Yan, ZHANG Feng, HU Peng, WANG Mingfei, HAN Shuai, SONG Xin, YU Tao, WANG Jian. Clinical efficacy of single hole split endoscopy assisted by ultrasound bone knife in the treatment of calcified lumbar disc herniation[J]. Chinese Journal of General Practice, 2024, 22(11): 1868-1871. doi: 10.16766/j.cnki.issn.1674-4152.003752
Citation: TAN Fang, ZHANG Yan, ZHANG Feng, HU Peng, WANG Mingfei, HAN Shuai, SONG Xin, YU Tao, WANG Jian. Clinical efficacy of single hole split endoscopy assisted by ultrasound bone knife in the treatment of calcified lumbar disc herniation[J]. Chinese Journal of General Practice, 2024, 22(11): 1868-1871. doi: 10.16766/j.cnki.issn.1674-4152.003752

Clinical efficacy of single hole split endoscopy assisted by ultrasound bone knife in the treatment of calcified lumbar disc herniation

doi: 10.16766/j.cnki.issn.1674-4152.003752
Funds:

 PKJ2022-Y37

 22ZR1455700

 PWZxk2022-16

  • Received Date: 2024-03-01
    Available Online: 2024-12-31
  •   Objective  To examine the clinical efficacy of ultrasonic osteotome-assisted one-hole split endoscopic discectomy (OSED) for calcified lumbar disc herniation (CLDH) and to provide a clinical reference point.  Methods  A retrospective analysis was conducted on 25 patients with CLDH who were treated at the Department of Orthopaedics in Shanghai Pudong New Area People's Hospital between January 2022 and February 2023. All patients underwent osteosynthesis with the assistance of an ultrasonic bone knife. It is crucial to meticulously observe and document the extent of surgical bleeding, the duration of the surgical procedure, the postoperative period required for patients to be able to get out of bed, the length of the incision, the frequency of intraoperative fluoroscopy, and any perioperative complications. A comparison of the visual analogue scale (VAS) and Oswestry disability Index (ODI) scores for low back pain and leg pain before and after surgery will be conducted. Furthermore, the area of calcified protrusions on the CT cross-section of intervertebral discs before and three months after surgery will be evaluated. Finally, the modified MacNab criteria will be employed to evaluate the surgical efficacy at the conclusion of the follow-up period.  Results  All 25 patients underwent surgical intervention without any significant complications, including vascular or nerve injury. The mean length of the incision was (2.01±0.26) cm, the mean surgical time was (87.40±12.84) min, the mean surgical bleeding volume was (52.40±28.33) mL, the mean frequency of intraoperative fluoroscopy was (2.88±1.01) times, and the mean postoperative time to get out of bed was (22.56±7.80) h. The VAS score and ODI index for lower back pain and leg pain in patients at different time points after surgery exhibited a statistically significant reduction compared to the pre-surgical period (P < 0.05). Moreover, the area of calcified material in the CT cross-section of the intervertebral disc demonstrated a significant reduction at the three-month post-surgical mark in comparison to the pre-surgical level (P < 0.001). The proportion of patients who were rated as excellent or good using the revised MacNab criteria was 92.0% (23/25).  Conclusion  The application of ultrasonic osteotome assisted OSED in the treatment of CLDH has satisfactory therapeutic effects, with advantages such as minimal trauma, sufficient removal of calcified protrusions, and fewer complications.

     

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