【晨读】经皮内镜下腰椎间盘摘除术：适应症和并发症（一）

 英语晨读 ·

山东省立医院疼痛科英语晨读已经坚持10余年的时间了，每天交班前15分钟都会精选一篇英文文献进行阅读和翻译。一是可以保持工作后的英语阅读习惯，二是可以学习前沿的疼痛相关知识。我们会将晨读内容与大家分享，助力疼痛学习。

本次文献选自Pan M , Li Q , Li S , et al. Percutaneous Endoscopic Lumbar Discectomy: Indications and Complications[J]. Pain physician, 2020, 23(1):49-56.本次学习由赵学军主任医师主讲。

ABSTRACT

Background: Percutaneous endoscopic lumbar discectomy (PELD) often refers to percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID). As a minimally invasive spinal procedure, PELD has gained increasing recognition for its small incision, quick recovery, short hospital stay, and equivalent clinical outcome compared to open surgery. In order to obtain satisfactory clinical efficacy, adequate consideration should be given regarding the indication of PELD. On the other hand, complications related to PELD will also significantly affect the safety and outcome of surgery.

Objective: Our objective was to conduct a literature review of the indications and complications of PELD and to provide our experience in patient selection and solutions to complications related to PELD.

Study Design: The study is a literature review focused on the indications and complications of PELD.

Setting: The study is a literature review on the indications and complications of PELD.

Methods: A comprehensive review of available literature on PELD was performed. Particular

focus was given to the development of indications and prevention of complications. The literature

was searched in PubMed database, and key words were set as “percutaneous endoscopic lumbar

discectomy”, “percutaneous endoscopic transforaminal discectomy”, “percutaneous endoscopic interlaminar discectomy”, “PELD”, “PETD”, “PEID”, “YESS” and “TESSYS”.

Results: PELD is an effective and safe treatment for lumbar disc herniation, lumbar spinal stenosis, recurrent lumbar disc herniation, and other lumbar diseases. Complications related to PELD include dural tear, nerve root injury, recurrence, and so on.

Limitations: Some results drawn in this review are based on retrospective study or small sample size. Studies of larger sample size and more multicenter, randomized controlled trials should be conducted to evaluate the clinical efficacy and safety of PELD.

Conclusions: PELD is a promising surgical technique for lumbar diseases. Proper patient selection, excellent surgical skills, and rich experience are required for satisfactory outcomes.

摘要：

背景：经皮内镜下腰椎间盘摘除术（PELD）通常指经皮内镜下经椎间孔椎间盘切除术（PETD）和经皮内镜下经椎板间椎间盘切除术（PEID）。作为一种微创脊柱手术，因其切口小、恢复快、住院时间短、与开刀手术临床疗效相当，PELD已经得到越来越多的重视。为了获得满意的临床疗效，应充分考虑关于PELD的适应症。另一方面，与PELD相关的并发症也将严重影响手术的安全性和结果。

目的：我们的目的是对适应症和并发症进行文献回顾并提供我们在病人选择和相关并发症解决方案方面的经验。

研究设计：本研究是一篇文献综述，主要讨论适应症和并发症。

研究环境：本研究是关于PELD适应症和并发症的文献综述。

方法：对现有的PELD相关文献进行综述。特别着重于是适应症的选择和并发症的预防。在PubMed数据库中检索，关键字设置为“经皮内镜下腰椎间盘切除术”、“经皮内镜下经椎间孔椎间盘切除术”、“经皮内镜下经椎板间椎间盘切除术”、“PELD”、“PETD”、“PEID”、“YESS”和“TESSYS”。

结果：PELD是治疗腰椎间盘突出症、腰椎管狭窄症、复发性腰椎间盘突出症和其他腰椎疾病的一种安全有效的治疗方法。与PELD相关的并发症包括硬脑膜撕裂、神经根损伤、复发等。

局限性：本研究的某些结果是基于回顾性研究或小样本研究得出的。为了评价PELD的临床疗效和安全性，尚需进行更大样本量和更多的多中心随机对照试验的研究。

结论：PELD是治疗腰椎疾病的一种有前途的手术方法。正确选择患者、良好的手术技巧和丰富的经验是取得满意效果的必要条件。

Key words: Complications, indications, minimally invasive spine surgery, PELD

关键词：并发症，适应症，微创脊柱手术，PELD