超声引导穿刺联合可视环锯在侧入路经皮椎间孔镜腰椎间盘髓核摘除术中的应用

注册号:

Registration number:

ChiCTR2600125953 

最近更新日期:

Date of Last Refreshed on:

2026-06-01 17:52:17 

注册时间:

Date of Registration:

2026-06-01 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

超声引导穿刺联合可视环锯在侧入路经皮椎间孔镜腰椎间盘髓核摘除术中的应用

Public title:

Application of ultrasound-guided puncture combined with visual trephine in percutaneous transforaminal endoscopic lumbar discectomy

注册题目简写:

English Acronym:

研究课题的正式科学名称:

超声引导穿刺联合可视环锯在侧入路经皮椎间孔镜腰椎间盘髓核摘除术中的应用

Scientific title:

Application of ultrasound-guided puncture combined with visual trephine in percutaneous transforaminal endoscopic lumbar discectomy

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

袁德超 

研究负责人:

刘世伟 

Applicant:

Dechao Yuan 

Study leader:

Shiwei Liu 

申请注册联系人电话:

Applicant telephone:

+86 13990725582

研究负责人电话:

Study leader's
telephone:

+86 813 2121556

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

749916536@qq.com

研究负责人电子邮件:

Study leader's E-mail:

lsw8896l79@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

四川省自贡市自流井区尚义灏一支路42号

研究负责人通讯地址:

自贡市大安区灯城西街1号

Applicant address:

No.42, Shangyihao Yi Zhi Road, Zigong, Sichuan.

Study leader's address:

No.1, DENGCHENG WEST AVENUE, DAAN DISTRICT, ZIGONG CITY

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

自贡市第一人民医院

Applicant's institution:

Zigong First People's Hospital

研究负责人所在单位:

自贡市第一人民医院

Affiliation of the Leader:

Zigong First People's Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2026年第026号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

自贡市第一人民医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Zigong First People's Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-31 00:00:00

伦理委员会联系人:

唐春梅

Contact Name of the ethic committee:

Tang ChunMei

伦理委员会联系地址:

自贡市大安区灯城西街1号

Contact Address of the ethic committee:

No.1, DENGCHENG WEST AVENUE, DAAN DISTRICT, ZIGONG CITY

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 813 2121556

伦理委员会联系人邮箱:

Contact email of the ethic committee:

191128684@qq.com

研究实施负责(组长)单位:

自贡市第一人民医院

Primary sponsor:

Zigong First People's Hospital

研究实施负责(组长)单位地址:

自贡市大安区灯城西街1号

Primary sponsor's address:

No.1, DENGCHENG WEST AVENUE, DAAN DISTRICT, ZIGONG CITY

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

四川省

市(区县):

Country:

China

Province:

Sichuan

City:

单位(医院):

自贡市第一人民医院

具体地址:

自贡市大安区灯城西街1号

Institution
hospital:

Zigong First People's Hospital

Address:

No.1, DENGCHENG WEST AVENUE, DAAN DISTRICT, ZIGONG CITY

经费或物资来源:

Source(s) of funding:

NA

研究疾病:

腰4/5椎间盘突出症  

Target disease:

Lumbar 4/5 Intervertebral Disc Herniation

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

探讨超声引导上关节突穿刺定位联合可视下环锯在侧入路经皮椎间孔镜腰椎间盘髓核摘除术(Percutaneous transforaminal endoscopic lumbar discectomy,PTELD)中的应用价值,并评估其临床疗效。  

Objectives of Study:

To investigate the value of ultrasound-guided facet puncture and localization combined with visual trephine in percutaneous transforaminal endoscopic lumbar discectomy (PTELD) via lateral approach, and to evaluate its clinical efficacy.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.合并腰椎不稳定;
2.合并马尾神经综合征。
3.合并腰椎管狭窄;
4.合并骨折、肿瘤或手术区活动性感染;
5.同时存在多个节段腰椎间盘突出;
6.复发的腰椎间盘突出症;
7.既往相应节段有手术史;
8.其他全身系统性疾病不能保持长时间俯卧位;
9.存在手术禁忌,不能耐受手术;

Exclusion criteria:

1.Combined lumbar instability.
2.Combined cauda equina syndrome.
3.Combined lumbar spinal stenosis;
4.Combined with fracture, tumor or active infection in the surgical area;
5.Multiple levels of lumbar disc herniation at the same time.
6.Recurrent lumbar disc herniation.
7.Previous history of surgery at the corresponding level.
8.Other systemic diseases cannot maintain a prolonged prone position.
9.There are surgical contraindications and cannot tolerate surgery.

研究实施时间:

Study execute time:

From 2026-05-31 00:00:00 To 2028-05-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-06-01 00:00:00 To 2027-12-31 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

30

Group:

Control group

Sample size:

干预措施:

采取C臂X线引导穿刺作为干预措施

干预措施代码:

Intervention:

C-arm X-ray-guided puncture was adopted as intervention measure

Intervention code:

组别:

观察组

样本量:

30

Group:

Observation group

Sample size:

干预措施:

采取超声引导穿刺定位作为干预措施

干预措施代码:

Intervention:

Ultrasound guided puncture localization was adopted as intervention measure

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

四川省 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

自贡市第一人民医院 

单位级别:

三级甲等 

Institution
hospital:

Zigong First People's Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

疼痛及功能评分

指标类型:

次要指标

Outcome:

Pain and Function Scores

Type:

Secondary indicator

测量时间点:

术前、术后3天、术后3月

测量方法:

记录两组患者术前及术后3天、3个月的疼痛视觉模拟评分(Visual analogue scale,VAS)和日本骨科协会腰评分(Japanese Orthopaedic Association scores,JOA)并进行比较分析。记录患者术前及术后3个月的Oswestry 功能障碍指数问卷表(Oswestry Dability Index,ODI)并进行比较分析。

Measure time point of outcome:

Before surgery, 3 days after surgery, and 3 months after surgery.

Measure method:

Record the Visual Analogue Scale (VAS) and Japanese Orthopaedic Association scores (JOA) for both groups of patients before surgery and 3 days and 3 months after surgery, and conduct a comparative analysis. Also, record the Oswestry Disability Index (ODI) for patients before surgery and 3 months after surgery, and perform a comparative analysis.

指标中文名:

椎间孔成形时神经刺激征

指标类型:

次要指标

Outcome:

Nerve stimulation signs during foraminotomy

Type:

Secondary indicator

测量时间点:

术中

测量方法:

在椎间孔成形过程中出现神经刺激症状的次数。

Measure time point of outcome:

Intraoperative

Measure method:

The number of instances of nerve irritation during foraminotomy surgery。

指标中文名:

手术时间

指标类型:

次要指标

Outcome:

Surgery Time

Type:

Secondary indicator

测量时间点:

术中

测量方法:

开始到结束的手术总时间,以及穿刺时间、椎间孔成形时间。

Measure time point of outcome:

Intraoperative

Measure method:

The total duration of the surgery from start to finish, as well as the time taken for the puncture and for the foraminotomy procedure.

指标中文名:

一次性穿刺成功率

指标类型:

主要指标

Outcome:

Disposable puncture success rate

Type:

Primary indicator

测量时间点:

术中

测量方法:

各组一次性穿刺成功的概率:一次性穿刺成功人数 / 总人数 *100%。

Measure time point of outcome:

Intraoperative

Measure method:

Probability of successful disposable puncture in each group: number of successful disposable puncture/total number of patients *100%.

指标中文名:

X线透视次数

指标类型:

主要指标

Outcome:

Number of fluoroscopy

Type:

Primary indicator

测量时间点:

术中

测量方法:

各组术中接受C臂透视的次数。

Measure time point of outcome:

Intraoperative

Measure method:

Number of C-arm fluoroscopies received during surgery in each group.

指标中文名:

基线资料收集

指标类型:

次要指标

Outcome:

Baseline data collection

Type:

Secondary indicator

测量时间点:

术前

测量方法:

收集患者基本信息:年龄、性别、身高、体重、BMI。

Measure time point of outcome:

Before surgery

Measure method:

Collect basic patient information: age, gender, height, weight, BMI.

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 79 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

由独立于本研究的统计师使用R软件(版本4.3.0)生成随机序列,设区组大小为4,按1:1比例将受试者分配至观察组或对照组。

Randomization Procedure (please state who generates the random number sequence and by what method):

An independent statistician generated the randomization sequence using R software (version 4.3.0), with the seed number obtained from the National Time Service Center physical random number service (March 15, 2024). Stratification was performed by sex (male/female), age (≤50 years/>50 years), and herniation type (contained/sequestrated). Within each stratum, block randomization with randomly varying block sizes (4 or 6) was used, with an allocation ratio of 1:1. The randomization sequence was encrypted and imported into a central randomization system. The research coordinator logged into the system on the day of surgery to obtain real-time group allocation.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

单盲,对评估者隐藏分组

Blinding:

Single blind study with blinded-evaluators

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

本研究的去标识化个体参与者数据(De-identified Individual Participant Data, IPD)及数据分析代码将在文章发表后12个月内,存储于Figshare开放科学平台(https://figshare.com),分配永久DOI链接。数据共享内容包括:基线特征数据集、主要/次要结局测量数据集、统计分析代码(R/Syntax)。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

The de-identified individual participant data and the data analysis code from this study will be stored on the Figshare open science platform (https://figshare.com) for 12 months after the publication of the article, and a permanent DOI link will be assigned. The shared data includes baseline characteristic datasets, primary/secondary outcome measurement datasets, and statistical analysis code (R/Syntax).

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

数据采集:本研究使用纸质病例报告表(CRF)模式采集患者信息。CRF依据研究方案专门设计,包含患者基线特征、术中实时记录(穿刺阶段、椎间孔成形阶段)及术后随访数据。术中关键指标(穿刺时间、透视次数)由不参与手术的巡回护士使用标准化计时器和计数器实时记录于纸质CRF,术后2小时内由研究护士转录至EDC系统,并交叉核对。EDC系统部署于医院本地服务器,配置自动验证规则(范围检查、逻辑跳转、时间序列验证)和审计追踪功能,确保数据实时质控。患者自评量表(VAS、ODI)通过EDC调查问卷功能在平板端完成,减少转录偏倚。数据管理:数据管理遵循《临床试验数据管理工作技术指南》及ALCOA+原则(可归因、清晰、同步、原始、准确、完整、一致、持久、可用)。设立专职数据管理员,制定数据管理计划(DMP),明确数据核查、质疑管理、锁定流程。关键变量(主要结局、随机化信息)100%源数据核查(SDV),一般变量10%抽查。数据库锁定前由独立统计师进行盲态数据审查,确认无异常模式后执行锁定。锁定后数据导出为SAS、CSV、R三种格式,用于统计分析和数据共享。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection: In this study, paper case report form (CRF) mode was used to collect patient information. The CRF was specifically designed according to the study protocol and contained patient baseline characteristics, intraoperative real-time records (puncture stage, foraminoplasty stage), and postoperative follow-up data. Critical intraoperative parameters (puncture time, fluoroscopy times) were recorded in paper CRFs in real time by circulating nurses who were not involved in the operation using standardized timers and counters, which were kept by a specially-assigned person in our study team to ensure real-time data quality control. Patient checklists (VAS, ODI) were completed via questionnaires to reduce transcriptional bias. Data management: Data management follows the Technical Guidelines for Data Management of Clinical Trials and ALCOA + principles (attributable, clear, synchronous, original, accurate, complete, consistent, durable and available). Establish a full-time data manager, develop a Data Management Plan (DMP), and clarify the data verification, query management and locking process. 100% Source Data Verification (SDV) for critical variables (primary outcome, randomization information) and 10% spot check for general variables. Blind data review was performed by an independent statistician prior to database lock and lock was performed after confirming no unusual patterns for statistical analysis and data sharing.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-06-01 17:52:10