摘要
目的探讨“U”路经皮椎间孔镜(PELD)手术治疗中央型椎管狭窄(LCSS)的安全性和术后1年临床疗效。方法回顾分析2017年1月至2019年6月上海市第十人民医院疼痛科及温州医科大学附属第二医院疼痛科第一诊断为LCSS并同意接受“U”路PELD手术治疗并完成术后1年随访的患者55例。记录患者性别、年龄、症状持续时间、手术持续时间和住院天数等基本临床资料,记录术后1 d、1个月、3个月、6个月和1年的腰背部和下肢视觉模拟量表(VAS)评分,并采用Oswestry功能障碍指数问卷表(ODI)评估患者生活质量,术前、术后3个月、6个月和1年采用改良Macnab评估患者临床预后。结果1例患者失访,54例患者完成1年随访。术后无神经根损伤、硬膜囊撕裂、脑脊液漏或感染等并发症发生。术后各时间点腰背部和下肢VAS评分以及ODI较术前显著降低(P<0.05)。术后3个月、6个月和1年的改良Macnab评估“总优良率”分别为92.59%、92.59%和98.15%,有显著改善(P<0.05)。无患者因症状复发需要接受二次微创或开放手术治疗。结论“U”路PELD为治疗LCSS有效且安全的手术方式,可显著改善LCSS患者的临床症状、提高其生活质量。
Objective To investigate the safety and clinical efficacy of percutaneous endoscopic lumbar discectomy(PELD)through“U”approach in the treatment of lumbar central spinal stenosis(LCSS)for 1 year after the operation.Methods A total of 55 patients who were first diagnosed with LCSS in the Department of Pain Clinic of Shanghai Tenth People’s Hospital and the Department of Pain Clinic of the Second Affiliated Hospital of Wenzhou Medical University from January 2017 to June 2019,agreed to receive PELD operation through"U"approach and completed 1-year follow-up after the operation were retrospectively analyzed.The basic clinical data such as gender,age,duration of symptoms,duration of operation and hospitalization days were recorded.The visual analogue scale(VAS)scores of lower back and lower limbs were recorded on the 1st day,1st month,3rd month,6th month and 1st year after the operation.The Oswestry dysfunction index(ODI)questionnaire was used to evaluate the patients’quality of life,and the clinical prognosis was evaluated by modified Macnab before the operation,3rd month,6th month and 1st year after the operation.Results 1 patient lost follow-up and 54 patients completed 1-year follow-up.There were no complications such as nerve root injury,dural sac laceration,cerebrospinal fluid leakage or infection that occurred after the operation.VAS score and ODI of low back and lower limb pain at each time point after the operation were significantly lower than those before the operation(P<0.05).The"total excellent and good rate"assessed by the improved Macnab at 3rd month,6th month and 1st year after the operation reached 92.59%,92.59%and 98.15%,respectively,with significant improvement(P<0.05).No patients needed to receive secondary minimally invasive or open surgery due to relapse of symptoms.Conclusion PELD through"U"approach is an effective and safe surgical method for the treatment of LCSS,and significantly improves the clinical symp toms and life quality of patients.
作者
齐慧
林福清
占恭豪
王兴鹏
尹路
QI Hui;LIN Fuqing;ZHAN Gonghao;WANG Xingpeng;YIN Lu(Hengyang Medical School,University of South China,Hunan,Hengyang 421001,China;Department of Anesthesiology,Shanghai Tenth People’s Hospital,Shanghai 200040,China;Department of Pain Clinic,the Second Affiliated Hospital of Wenzhou Medical University,Zhejiang,Wenzhou 325027,China;Department of General Surgery,Shanghai Tenth People’s Hospital,Shanghai 200040,China)
出处
《中国医药科学》
2022年第12期121-125,共5页
China Medicine And Pharmacy
关键词
“U”路
经皮椎间孔镜
椎管狭窄
中央型
"U"approach
Percutaneous endoscopic lumbar discectomy
Spinal st enosis
Central type
