摘要
目的探讨经皮椎间孔镜可视化椎间孔成形术治疗老年侧隐窝型腰椎狭窄症的临床效果。方法选取2017年9月至2018年12月诊断为侧隐窝型腰椎狭窄症的老年患者共54例,根据患者及其家属意愿将其分为可视化椎间孔成形术组(可视化组)28例和标准TESSYS椎间孔成形术组(TESSYS组)26例,比较2组患者的术中透视次数、椎间孔成形时间、手术时间、手术前后VAS、并发症发生率和术后6个月改良Macnab疗效评定。结果可视化组术中透视次数、椎间孔成形时间和手术时间少于TESSYS组,差异有统计学意义(P<0.05);2组术后VAS较术前降低,差异有统计学意义(P<0.05);2组并发症发生率、术前和术后2 d、3个月、6个月的VAS以及术后6个月改良Macnab疗效评定比较,差异无统计学意义(P>0.05)。结论可视化椎间孔成形术和标准TESSYS椎间孔成形术治疗老年侧隐窝型腰椎狭窄症的近期疗效相近,但可视化椎间孔成形术可明显减少患者术中透视次数、椎间孔成形时间及手术时间。
Objective To investigate the clinical effect of visual foraminoplasty in the treatment of elderly lumbar lateral recess stenosis with spinal endoscopy.Methods From September 2017 to December 2018,a total of 54 elderly patients diagnosed as lumbar recess stenosis were enrolled.According to the wishes of patients and their families,they were divided into the visual foraminoplasty group(visual group,28 cases)and the standard TESSYS foraminoplasty group(TESSYS group,26 cases).The times of fluoroscopy,forming time of intervertebral foramen,total operation time,preoperative and postoperative VAS score,incidence of surgical complications and the improved Macnab score 6 months after surgery were compared between the two groups.Results The times of fluoroscopy,forming time of intervertebral foramen,total operation time in the visual group were less than those in the TESSYS group,and there were significant differences between the two groups(P<0.05).The VAS scores of the two groups were significantly lower than those before operation(P<0.05).There was no significant differences in operative complications,VAS scores of the two groups before surgery,2 days,3 months,6 months after surgery,and the improved Macnab score 6 months after surgery(P>0.05).Conclusion Visual foraminoplasty and standard TESSYS foraminoplasty have the same effect for the treatment of lumbar lateral recess stenosis in elderly patients.Visual foraminoplasty can significantly reduce the times of fluoroscopy,forming time of intervertebral foramen and total operation time.
作者
史册
高运
朱爱祥
杨春
杨光辉
朱裕成
郑红兵
王冰
SHI Ce;GAO Yun;ZHU Ai-xiang;YANG Chun;YANG Guang-hui;ZHU Yu-cheng;ZHENG Hong-bing;WANG Bing(Department of Othopedics,Suqian Hospital Affiliated to Xuzhou Medical University,Suqian Jiangsu 223800,China;Department of Othopedics,Third Affiliated Hospital of Medical Department of Soochow University,Changzhou Jiangsu 213000,China)
出处
《局解手术学杂志》
2019年第12期956-960,共5页
Journal of Regional Anatomy and Operative Surgery
基金
江苏省重点研发计划(社会发展)面上项目(BE2019703)
宿迁市科技创新专项-重点研发计划(社会发展支撑)项目(S201805)
关键词
可视化椎间孔成形术
经皮椎间孔镜
侧隐窝型腰椎管狭窄症
微创
老年患者
神经根减压
visual foraminoplasty
percutaneous transforaminal endoscope
lumbar lateral recess stenosis
minimally invasive
elderly patients
nerve root decompression
