摘要
目的 观察经皮后路非全内镜下椎间孔内口减压术(Percutanous endoscopic medial foraminal discectomy,PEMFD)联合皮质骨轨迹螺钉内固定治疗腰椎神经根管狭窄症的疗效。方法 回顾性分析自2020-09-2022-09诊治的80例腰椎神经根管狭窄症,其中A组30例采用PE-MFD治疗,B组30例采用全脊柱内镜下椎板开窗减压术(Full endoscopic fenestration discectomy,Endo-LOVE)治疗,C组20例采用PE-MFD联合皮质骨轨迹螺钉内固定。比较三组手术相关参数、并发症发生率,以及术后3 d、3个月疼痛VAS评分、ODI指数。结果 80例随访时间3~6个月,平均3.54个月。A组、C组手术时间较B组长(P<0.05),但是A组、C组手术时间差异无统计学意义(P>0.05)。C组术中出血量、术后3 d疼痛VAS评分明显小于A组、B组(P<0.05)。三组住院时间、术后3个月疼痛VAS评分、ODI指数、术后并发症发生率差异均无统计学意义(P>0.05)。结论 PE-MFD联合皮质骨轨迹螺钉内固定治疗腰椎神经根管狭窄症的疗效满意,不仅缩短手术时间、降低术中出血量,而且有利于缓解患者早期疼痛,值得临床推广应用。
Objective To observe the efficacy of percutaneous posterior endoscopic intervertebral foramen medial foraminal decompression(PE-MFD)combined with cortical bone tracking screw internal fixation in the treatment of lumbar nerve root ca-nal stenosis.Methods A retrospective analysis was conducted on 80 cases of lumbar nerve root canal stenosis diagnosed and treated from September 2020 to September 2022.Among them,30 cases group A were treated with PE-MFD,30 cases group B were treated with full endoscopic fenestration discectomy(Endo LOVE),and 20 cases group C were treated with PE-MFD com-bined with cortical bone trajectory screw internal fixation.The surgical related parameters,incidence of complications,as well as pain VAS score and ODI index at 3 days and 3 months after surgery were compared among the three groups.Results The follow-up time was 3-6 months,with an average of 3.54 months.The surgical time of group A and group C was longer than that of group B(P<0.05),but there was no statistically significant difference in surgical time between group A and group C(P>0.05).The intraoperative bleeding volume and postoperative pain VAS score of group C were significantly lower than those of group A and group B(P<0.05).There were no statistically significant differences in hospital stay,pain VAS score,ODI index,and postop-erative complications among the three groups(P>0.05).Conclusion The efficacy of PE-MFD combined with cortical bone tra-jectory screw internal fixation in the treatment oflumbar nerve root canal stenosis is satisfactory.It not only shortens the surgical time,reduces intraoperative bleeding,but also helps to alleviate early pain in patients,which is worthy of clinical promotion.
作者
王振
郭炼锦
张勋梦
WANG Zhen;GUO Lianjin;ZHANG Xunmeng(Department of Orthopedic,the Fourth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 511300,China)
出处
《中国骨与关节损伤杂志》
2023年第9期917-920,共4页
Chinese Journal of Bone and Joint Injury
关键词
腰椎神经根管狭窄症
经皮侧后路非全内镜下椎间孔内口减压术
皮质骨轨迹螺钉
Lumbar nerve root canal stenosis
Percutaneous posterior approach decompression of foraminal internal opening un-der incomplete endoscope
Cortical bone track screw
