摘要
目的对比分析经椎间孔脊柱内窥镜系统(TESSYS)与BEIS(broad easy immediate surgery)技术在治疗单节段腰椎椎管狭窄症中的疗效。方法回顾性分析2017年6月-2019年10月接受手术治疗的400例单节段腰椎椎管狭窄症患者临床资料,其中200例采用BEIS技术治疗(BEIS组),200例采用TESSYS治疗(TESSYS组)。记录术中出血量、手术时间、住院时间及并发症发生情况,分别于术前,术后3 d、3个月、12个月及末次随访时采用疼痛视觉模拟量表(VAS)评分评估腰腿痛程度,采用Oswestry功能障碍指数(ODI)评估腰椎功能,采用Nakai标准评价疗效。结果所有手术顺利完成,所有患者随访时间超过12个月,所有患者未发生术中神经根损伤及术后切口感染、椎间隙感染等并发症。TESSYS组术中出血量明显少于BEIS组,手术时间、住院时间明显短于BEIS组,差异均有统计学意义(P<0.05)。2组术后各时间点VAS评分、ODI均较术前明显改善,差异有统计学意义(P<0.05),且随着时间延长,VAS评分、ODI逐渐下降;TESSYS组术后各时间点VAS评分、ODI低于BEIS组,差异均有统计学意义(P<0.05)。TESSYS组疗效优良率为93.50%,BEIS组疗效优良率为86.00%,组间差异有统计学意义(P<0.05)。结论TESSYS治疗单节段腰椎椎管狭窄症,手术创伤小,能有效缓解腰腿痛,改善腰椎功能,疗效优于BEIS技术。
Objective To compare and analyze the efficacy of transforaminal endoscopic spinal system(TESSYS)and BEIS(broad easy immediate surgery)in the treatment of single-segment lumbar spinal stenosis.Methods The clinical data of 400 patients with single-segment lumbar spinal stenosis who received surgery from June 2017 to October 2019 were analyzed retrospectively.Among them,200 cases were treated with BEIS(BEIS group),and 200 with TESSYS(TESSYS group).Intraoperative blood loss,operation time,hospital stay and complications were recorded.At pre-operation,postoperative 3 d,3 months and 12 months and the final follow-up,the visual analogue scale(VAS)score was used to evaluate the low back and leg pain,and the Oswestry disability index(ODI)was used to evaluate the lumbar function.The therapeutic effect was evaluated by Nakai criteria.Results All the operations were successfully completed.All the patients were followed up for more than 12 months.No intraoperative nerve root injury,postoperative incision and intervertebral space infections and other complications occurred in all the patients.The intraoperative blood loss of TESSYS group was significantly less than that of BEIS group,and the operation time and hospital stay were significantly shorter than those of BEIS group(P<0.05).The VAS scores and ODI at each time point after operation were significantly improved compared with those before operation in the 2 groups,all with a statistically significance(P<0.05);and as time went on,VAS score and ODI decreased gradually.The VAS scores and ODI of TESSYS group were lower than those of BEIS group at each time point after operation,and the differences were statistically significant(P<0.05).The excellent and good rate of TESSYS group was 93.50%,BEIS group 86.00%,and the difference was statistically significant(P<0.05).Conclusion TESSYS for treatment of single-segment lumbar spinal stenosis has a minimal invasion,can effectively relieve low back and leg pain,improve lumbar function,and its efficacy is better than BEIS.
作者
崔涛
肖英博
李海芳
刘科举
Cui Tao;Xiao Yingbo;Li Haifang;Liu Keju(Department of Pain,Qinhuangdao Third Hospital,Qinhuangdao 066000,Hebei,China)
出处
《脊柱外科杂志》
2021年第6期382-386,共5页
Journal of Spinal Surgery
基金
秦皇岛市科学技术研究与发展计划项目(202004A020)。
关键词
腰椎
椎管狭窄
内窥镜检查
外科手术
微创
Lumbar vertebrae
Spinal stenosis
Endoscopy
Surgical procedures,minimally invasive
