论著

TESSYS 技术对腰椎间盘突出症患者疼痛及功能的影响

The impact of TESSYS technology on pain and function in patients with lumbar disc herniation

:352-358
 
       目的  分析改良经脊柱内椎间孔镜系统技术(TESSYS)对腰椎间盘突出症患者疼痛及功能的影响,以期分析该术式优劣,丰富该研究领域。方法  回顾性选取2022年10月—2024年10月医院治疗的80例腰椎间盘突出症患者作为研究对象,根据治疗方式的不同划分为观察组(TESSYS技术治疗)和对照组(经皮椎间孔镜髓核摘除术治疗),每组各40例。观察两组患者疗效、手术时间、术中出血量、住院时间、透视次数、切口长度等情况。比较两组患者术前、术后6 h、术后1天、术后1周、术后1个月VAS评分情况,比较两组患者术前及术后1个月腰椎功能情况,包括Oswestry功能障碍指数(ODI)、腰椎曲度、腰背肌后伸活动度。比较两组患者术前及术后24 h的血清超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平。结果   观察组患者疗效优于对照组(Z=-3.737,P<0.001)。交互效应下,两组疼痛因不同术式而随着时间增加而有所不同(P<0.05);时点效应下,观察组、对照组各组均随着时点增加疼痛随之减少(P<0.05);组间效应下,干预前、干预后1个月两组差异不明显,但是观察组疼痛干预后6 h(Z=-2.831,P=0.005)、干预后1天(Z=-3.253,P=0.001)低于对照组。术后1个月,观察组患者的ODI(Z=-4.804,P<0.001)低于对照组,而腰椎曲度(Z=-6.218,P<0.001)、腰背肌后伸活动度(Z=-7.014,P=0.001)高于对照组。术后24 h后,观察组患者的hs-CRP(Z=-5.671,P<0.001)、IL-6(Z=-3.262,P<0.001)低于对照组。结论  TESSYS相较于经皮椎间孔镜髓核摘除术在治疗腰椎间盘突出症时具有显著优势,可提高疗效,减少出血量,减轻疼痛,减少炎症反应,加快腰椎功能康复,缩短住院时间。
       Objective  The effect of modified transforaminal endoscopic spine system(TESSYS) on pain and function in patients with lumbar disc herniation was analyzed,so as to analyze the advantages and disadvantages of this procedure and enrich the research field.Methods  Retrospectively,80 patients with lumbar disc herniation treated in the hospital from October 2022 to October 2024 were selected as the study subjects.These patients were divided into two groups based on their treatment methods:the observation group(treated with TESSYS technology)and the control group(treated with percutaneous endoscopic discectomy).Each group consisted of 40 patients.The study evaluated the treatment efficacy,surgical duration,intraoperative bleeding volume,hospital stay fluoroscopy frequency,and incision length for both groups.Additionally,we compared the VAS  scores of  both groups before surgery,six hours post-surgery,one day post-surgery,one week post-surgery,and one month post-surgery.We also compared the lumbar function of both groups before surgery and 1 month post-surgery,including the Oswestry Functional Index(ODI),lumbar lordosis,and lumbar back muscle extension activity.Furthermore,we compared the serum levels of high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)in both groups before and 24 hours after surgery.Results  The therapeutic effect of the observation group was better than that of the control group(Z=-3.737,P<0.001).Under the interaction effect,the pain of the two groups varied with time due to different surgical procedures(P<0.05).Under the time effect,both the observation group and the control group showed a decrease trend in pain as the time to treatment increased(P<0.05).Under the inter group effect,there was no significant difference between the two groups before and 1 month after intervention,but the pain in the observation group was less than that in the control group at 6 hours after intervention(Z=-2.831,P=0.005)and 1 day after intervention(Z=-3.253,P=0.001).One month after surgery,the ODI(Z=-4.804,P<0.001)of the observation group patients was lower than that of the control group,while the lumbar curvature(Z=-6.218,P<0.001)and lumbar back muscle extension activity(Z=-7.014,P=0.001)were higher than those of the control group.Twenty-four hours after surgery,the hs-CRP(Z=-5.671,P<0.001)and IL-6(Z=-3.262,P<0.001)levels in the observation group were lower than those in the control groupConclusions  The improved  percutaneous transforaminal endoscopic technique  has  significant advantages over  percutaneous transforaminal discectomy in the treatment of lumbar disc herniation.It can improve efficacy,reduce bleeding,alleviate pain,reduce inflammatory reactions,accelerate lumbar functional recovery,and shorten hospitalization time.
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