摘要
腰椎管狭窄症(lumbar spinal stenosis,LSS)的患病率逐年递增,严重影响中老年人的身体健康和生活质量。目前常用的LSS脊柱内镜治疗方法有单侧双通道内镜技术(unilateral biportal endoscopy,UBE)、单孔分体内镜技术(one-hole split endoscopy,OSE)、同轴内镜技术(即椎间孔镜技术,percutaneous transforaminal endoscopic discectomy,PTED)。OSE治疗LSS具有操作时间短、术中出血少、手术创伤小、术后恢复快等特点,创伤较UBE更小,对椎管及双侧神经根管的减压较PTED更彻底。虽然OSE这项技术被成功应用于临床治疗已经4年余,但普及程度尚不够,目前缺乏OSE治疗LSS的专家共识和指南。为提高脊柱外科医生对OSE技术的认识,在中华中医药学会脊柱微创专家委员会、中国康复医学会骨伤康复专业委员会、中国医师协会骨科医师定期考核专业委员会脊柱外科专家组的主办下,在山东省老年医学会基层医疗工作委员会的协办下,于2022年8月20日在山东省老年医学会基层医疗工作委员会OSE脊柱微创学组成立大会上,OSE专家成员参考世界卫生组织推荐的指南制订方法,通过调查确定拟解决的重要临床问题,并对OSE、UBE、PTED领域已发表的相关文献进行系统评价,基于当前的循证医学证据,经德尔菲法投票及专家组讨论,提出推荐意见。后经反复论证,对OSE治疗腰椎管狭窄症形成共识,包括OSE的适应证、禁忌证、诊断、手术方式、手术流程、术后康复注意事项及术前术后评估,旨在为脊柱外科医生采用OSE技术治疗LSS的诊疗决策提供依据和临床指导,以提高中国LSS的脊柱内镜诊疗水平。
The incidence of lumbar spinal stenosis(LSS)is increasing year by year,which has seriously affected the physical health and quality of life of middle-aged and elderly people.At present,the commonly used methods for spinal endoscopic treatment of LSS include unilateral biportal endoscopy(UBE),One-hole Split Endoscopy(OSE),and percutaneous transforaminal endoscopic discectomy(PTED).The trauma of OSE for LSS is smaller than that of UBE(one surgical pathway).OSE has more thorough decompression of the spinal canal and nerve root than PTED.OSE has the advantages of short surgical operation time,less intraoperative bleeding,less surgical trauma,and fast postoperative recovery.Although OSE technology has been successfully applied in clinical treatment for 4 years,its awareness and popularity are still insufficient.At present,there is a lack of expert consensus and guidelines for OSE treatment of LSS.To further improve the understanding and mastery level of OSE among spinal surgeons,Under the sponsorship of the Spinal Minimally Invasive Expert Committee of the Chinese Society of Traditional Chinese Medicine,the Orthopaedic Rehabilitation Professional Committee of the Chinese Rehabilitation Medicine Association,and the Spinal Surgery Expert Group of the Orthopaedic Physician Regular Assessment Professional Committee of the Chinese Medical Association,and with the cooperation of the Basic Medical Work Committee of the Shandong Geriatrics Association,OSE expert members refer to the guidelines recommended by the World Health Organization to develop methods,determine important clinical problems to be solved through investigation,and evaluate literatures published in the field of OSE,UBE,PTED.Based on current evidence-based medicine,recommendations were ultimately formed through Delphi voting and expert group discussions,covering the indications,contraindications,diagnosis,surgical methods,surgical procedures,postoperative rehabilitation considerations,and preoperative and postoperative evaluations of OSE.The aim was to provide
作者
中华中医药学会脊柱微创专家委员会
中国康复医学会骨伤康复专业委员会
中国医师协会骨科医师定期考核专业委员会脊柱外科专家组
山东省老年医学会基层医疗工作委员会OSE脊柱微创学组
黄卫国
朱腾月
司海朋
冯毅
丁宇
孙兆忠
Minimally Invasive Spine Expert Committee of the Chinese Association of Traditional Chinese Medicine;Orthopaedic Rehabilitation Committee of Chinese Association of Rehabilitation Medicine;Spine Surgery Expert Group of the Orthopaedic Surgeon Regular Examination Professional Committee of the Chinese Medical Doctor Association;OSE Minimally Invasive Spine Group of Primary Care Working Committee of Shandong Geriatrics Association;Huang Weiguo(不详;Department of Orthopaedics,Civil Aviation General Hospital,Affiliated School of Civil Aviation Clinical Medicine,Peking University)
出处
《实用骨科杂志》
2024年第3期193-198,共6页
Journal of Practical Orthopaedics
关键词
单孔分体内镜技术
腰椎管狭窄症
治疗
one-hole split endoscopy
lumbar spinal stenosis
treatment
