摘要
目的探讨椎间孔入路经皮内镜下椎管减压术治疗退变性腰椎管狭窄症的临床疗效。方法采用椎间孔入路经皮内镜下椎管减压术治疗35例退变性腰椎管狭窄症患者。采用疼痛VAS评分评估术后腰、腿痛,采用ODI和MacNab评分评价术后腰椎功能。结果患者均获得12个月随访。术中未出现大血管损伤、内脏损伤、神经根损伤、硬膜囊破裂等严重并发症。切口均一期愈合。术后无椎间隙感染、腰椎不稳发生。术后1例发生腰椎间盘突出,2例出现出口神经根支配区域的感觉麻木或烧灼感。腰、腿痛VAS评分及ODI术后各时段均较术前显著降低(P<0.05)。末次随访时根据MacNab评分标准评价疗效:优19例,良13例,可2例,差1例,优良率91.4%。结论椎间孔入路经皮内镜下椎管减压术治疗退变性腰椎管狭窄症是一种微创、高效且安全的手术技术。
Objective To explore the clinical effect of percutaneous endoscopic spinal canal decompression via transforaminal approach in the treatment of degenerative lumbaRspinal stenoses.Methods The 35 cases of degenerative lumbaRspinal stenoses were treated with percutaneous endoscopic spinal canal decompression via transforaminal approach.The pain VAS was used to evaluate postoperative lumbar-leg pain,and the ODI and MacNab scores were used to evaluate postoperative lumbaRspine function.Results All patients were followed up foR12 months.There were no serious complications such as injuries of large blood vessels and internal organ,nerve root injury,rupture of the dural sac during the operation.The incisions healed in one-stage.No intervertebral space infection and lumbaRinstability occurred afteRoperation.Postoperative lumbaRdisc herniation occurred in 1 case,there were 2 cases of sensory numbness oRburning sensation in the area innervated by the outlet nerve root.The VAS of lumbar-leg pain and ODI at each postoperative period were significantly improved,compared with the preoperation(P<0.05).At the last follow-up,the efficacy was evaluated according to the MacNab scoring standard:19 cases were excellent,13 cases were good,2 cases fair,and 1 case poor,the excellent-good rate was 91.4%.Conclusions In the treatment of lumbaRspinal stenosis,percutaneous endoscopic spinal canal decompression via transforaminal approach is a minimally invasive,efficient and safe surgical technique.
作者
秦春跃
沈锐
李传和
李运远
杨振中
QIN Chun-yue;SHEN Rui;LI Chuan-he;LI Yun-yuan;YANG Zhen-zhong(SectionⅡ,Dept of Orthopaedics,Lu′an Civily Hospital,Lu′an,Anhui 237000,China)
出处
《临床骨科杂志》
2022年第2期184-188,共5页
Journal of Clinical Orthopaedics
关键词
退变性腰椎管狭窄症
经皮内镜椎管减压术
degenerative lumbaRspinal stenosis
percutaneous endoscopic spinal canal decompression
