Đánh giá kết quả vi phẫu thuật lấy nhân đệm trên bệnh nhân thoát vị đĩa đệm thắt lưng - cùng có mảnh rời=Evaluation on results of microdiscectomy for sequestered lumbar disc herniation

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Minh Quang Hồ, Anh Khoa Lê, Anh Tuấn Phạm, Nghị Lân Trần, Thành Nghĩa Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2024

Mô tả vật lý: tr.82-88

Bộ sưu tập: Metadata

ID: 242650

Thêm vào giỏ

Nghiên cứu nhằm mục đích mô tả đặc điểm lâm sàng, cận lâm sàng và đánh giá kết quả vi phẫu thuật lấy nhân đệm trên bệnh nhân thoát vị đĩa đệm thắt lưng - cùng có mảnh rời. Đối tượng và phương pháp nghiên cứu: Hồi cứu mô tả và phân tích hàng loạt ca bệnh. Các trường hợp được vi phẫu thuật lấy thoát vị đĩa đệm cột sống thắt lưng có mảnh rời tại khoa Ngoại Thần kinh, Bệnh viện Nguyễn Tri Phương từ tháng 10/2019 đến tháng 6/2022. Bệnh nhân được đánh giá triệu chứng lâm sàng, hình ảnh học trước phẫu thuật
đánh giá mức độ cải thiện triệu chứng sau phẫu thuật theo thang điểm VAS và Macnab. Kết quả: Có 37 trường hợp, gồm 21 nam và 16 nữ, trẻ nhất 26 tuổi, già nhất 76 tuổi, được vi phẫu thuật lấy nhân đệm thoát vị có mảnh rời. Mức độ đau theo rễ thần kinh theo thang điểm VAS tại thời điểm trước phẫu thuật và sau phẫu thuật 24 giờ lần lượt là 8,11 ± 0,90 điểm và 2,30 ± 1,35 điểm. Tại thời điểm sau phẫu thuật 3 tháng, kết quả rất tốt chiếm 62,2% và tốt chiếm 37,8%. Ghi nhận 1 trường hợp rách màng cứng được xử lý trong lúc phẫu thuật. Không ghi nhận các biến chứng khác tại thời điểm 3 tháng sau phẫu thuật. Kết luận: Vi phẫu thuật lấy nhân đệm trên bệnh nhân thoát vị đĩa đệm thắt lưng - cùng có mảnh rời đạt hiệu quả tốt, ít biến chứng.The study aims to describe the clinical and paraclinical characteristics and evaluate the results of microdiscectomy in patients with lumbosacral disc herniation with fragmented fragments. Research subjects and methods: Retrospective description and analysis of a series of cases. Cases undergoing microsurgery to remove lumbar disc herniation with fragmented fragments at the Department of Neurosurgery, Nguyen Tri Phuong Hospital from October 2019 to June 2022. Patients were evaluated for clinical symptoms and imaging before surgery
assess the level of symptom improvement after surgery according to the VAS and Macnab scales. Results: There were 37 cases, including 21 men and 16 women, the youngest 26 years old, the oldest 76 years old, who underwent microsurgery to remove the herniated nucleus pulposus with loose fragments. The level of nerve root pain according to the VAS scale at the time before surgery and immediately after surgery 24 hours was 8.11 ± 0.90points and 2.30± 1.35 points, respectively. At 3 months after surgery, very good results accounted for 62.2% and good results accounted for 37.8%. Recorded 1 case of dural tear that was treated during surgery. No other complications were noted at 3 months after surgery. Conclusion: Microsurgery to remove the nucleus pulposus on patients with lumbar disc herniation with separate fragments achieved good results with few complications.

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