| 李武,吕超,陈兴银,等.Delta大通道内镜与PTED治疗单节段腰椎间盘突出症的效果比较.骨科,2026,17(4): 338-342. |
| Delta大通道内镜与PTED治疗单节段腰椎间盘突出症的效果比较 |
| Comparative study of Delta large-channel endoscopy and percutaneous transforaminal endoscopic discectomy for the treatment of single-segment lumbar disc herniation |
| 投稿时间：2025-10-11 |
| DOI：10.3969/j.issn.1674-8573.2026.04.006 |
| CN KeyWords: 腰椎间盘突出症 单节段 Delta大通道内镜 椎间盘切除术 |
| EN KeyWords: Lumbar disc herniation Single-segment Delta large-channel endoscopy Discectomy |
| Fund Project:荆门市科学技术研究与开发计划项目（2025YDKY145） |
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| CN Abstract: |
| 目的 比较Delta大通道下经椎板间入路髓核摘除术与经皮椎间孔镜下椎间盘切除术（PTED）治疗单节段腰椎间盘突出症（LDH）的疗效。方法 采用回顾性队列研究，将我科2023年6月至2024年6月收治的60例单节段LDH患者根据术式分为两组，其中Delta组30例，男16例，女14例，年龄为（52.47±12.16）岁（32~73岁）；PTED组30例，男20例，女10例，年龄为（58.5±13.37）岁（34~82岁）。比较两组手术时间、住院费用、术中透视次数、疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）和手术并发症情况。结果 Delta组手术时间少于PTED组[（79.33±15.42） min vs. （92.07±13.06） min]，术中透视次数少于PTED组[（4.70±1.37）次 vs. （7.90±2.77）次，住院费用高于PTED组[（19 164.60±2 043.52）元 vs. （16 589.73±2 197.02）元]，差异均有统计学意义（P<0.05）。两组术后VAS评分、ODI均较术前明显改善（P<0.05），且术后第1周时，PTED组的VAS评分、ODI均显著优于Delta组（P<0.05），但两组此后的VAS评分、ODI比较，差异无统计学意义（P>0.05）。两组并发症发生率比较（6.67% vs. 3.33%），差异无统计学意义（P>0.05）。结论 Delta大通道下经椎板间入路髓核摘除术与PTED均能有效治疗LDH，临床上应根据患者病情及术者的操作习惯选择合适的手术方式，以期最大程度提高治疗效果和患者满意度。 |
| EN Abstract: |
| Objective To compare the efficacy of Delta large-channel endoscopy via interlaminar approach versus percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of single-segment lumbar disc herniation (LDH). Methods A retrospective cohort study was conducted on 60 patients with single-segment lumbar disc herniation admitted between June 2023 and June 2024. Patients were divided into two groups based on surgical technique: Delta group [30 cases, 16 males, 14 females, aged (52.47±12.16) years, range 32-73 years] and PTED group [30 cases, 20 males, 10 females, aged (58.5±13.37) years, range 34-82 years]. Operation time, hospitalization costs, intraoperative fluoroscopy frequency, visual analogue scale (VAS) pain scores, Oswestry Disability Index (ODI), and surgical complications were compared between groups. Results The Delta group had shorter operation time than the PTED group [(79.33±15.42) min vs. (92.07±13.06) min], fewer intraoperative fluoroscopy exposures [(4.70±1.37) times vs. (7.90±2.77) times], and higher hospitalization cost [(19 164.60±2 043.52) yuan vs. (16 589.73±2 197.02) yuan], with statistically significant differences (P<0.05). Both groups showed significant postoperative improvement in VAS and ODI compared to baseline (P<0.05). At one week postoperatively, the PTED group demonstrated significantly better VAS scores and ODI than the Delta group (P<0.05); however, subsequent comparisons showed no significant differences between groups (P>0.05). Complication rates were comparable between groups (6.67% vs. 3.33%, P>0.05).Conclusion Both Delta large-channel endoscopy via interlaminar approach and PTED are effective for treating LDH. Clinically, the selection of the surgical method should be based on the patient's condition and the surgeon's operational habits to maximize the treatment effect and patient satisfaction. |
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