[Objective] To evaluate the feasibility and efficacy of treatment for low back pain with percutaneous endoscopic lumbar discectomy (PELD). [ Method ] From November 2008~December 2009, 79 patients with low back pain were treated with PELD, which included 48 males and 31 females with average age of 49. 1 years (range, from 16 to 81 years). There were ordinary lumbar disc herniation in 67 cases (44 cases with mild for aminal stenosis), 6 cases of far later al lumbar disc herniation, discogenic low back pain in 6 cases. Retrospective analysis of clinical results was performed. The clinical outcomes were determined using a modified Macnab criteria and patient satisfaction. [Result] The average operative time was 50 minutes ( range, 30~100min), with a mean postoperative hospital stay of 5.6 days ( range, 2~30 days). There were neither complications related to the surgery, nor any conversion to open surgery. 79cases were followed up 12-25 months (average 19.3 months). The Visual analog scale (VAS) scores of preoperation, 1 week after operation and last follow-up were (8.75±0.25), (4.12±0.51), and (3.86±0.43) respectively (P <0.01). One patient had an increased pain in the final follow up compared with preoperative. Excellent and good rate was70.9%, satisfaction rate was 63.3%. [Conclusion] PELD can achieve satisfactory short-term clinicalresults in treating low back pain and is a safe and efficacious minimally invasive surgical technique. Appropriate case selection is very important.%目的 探讨经皮椎间孔镜下腰椎间盘切除术(PELD)治疗下腰痛的可行性和有效性.方法 回顾性 总结2008年11月～2009年12月采用PELD治疗下腰痛患者79例,其中普通腰椎间盘突出症67例(合并轻度椎间孔狭窄44例),极外侧型腰椎间盘突出症6例,盘源性腰痛6例,所有椎间盘突出的均为包客型.于术前、术后1周及末次随访时进行视觉模拟疼痛评分(VAS),末次随访时按改良Macnab标准及患者满意度评价临床疗效.结果 手术时间30～100 min,平均50 min；术后住院时间2～30 d,平均5.6d.无手术并发症及转为其他手术方式.随访12～25个月,平均19.3个月.术前、术后1周及末次随访残余疼痛评分(VAS)分别是(8.75±0.25)、(4.12±0.51)、(3.86±0.43)分(p＜0.05),1例患者末次随访时疼痛较术前加重.改良Macnab标准评价优良率70.9％,患者满意率63.3％.结论 PELD治疗下腰痛安全且近期效果良好,恰当的病例选择非常重要.
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