摘要
目的观察经皮内镜减压治疗腰椎融合术后邻近节段疾病的临床疗效。方法回顾性分析我院2020年1月~2022年6月26例经皮内镜减压治疗腰椎融合术后邻近节段疾病的临床资料,其中经椎间孔入路11例,经椎板间入路15例。单侧减压21例,双侧减压5例。用疼痛视觉模拟评分(Visual Analogue Scale,VAS)、Oswestry功能障碍指数(Oswestry Disability Index,ODI)、日本骨科协会(Japanese Orthopedic Association,JOA)评分和改良MacNab标准评估疗效。结果手术均顺利完成,未出现并发症。手术时间(85.4±21.7)min,手术出血量(19.8±5.9)ml,术中透视次数(7.7±2.4)次。术后即刻下肢疼痛VAS评分显著降低(P=0.000)。术后随访10~24个月,(16.0±3.7)月。术后3个月、末次随访VAS评分及ODI较术前均显著降低(F=105.444、852.714,均P=0.000),JOA评分显著增加(F=256.222,P=0.000)。末次随访疗效为优18例(69.2%),良5例(19.2%),可3例(11.5%),优良率88.5%(23/26)。结论经皮内镜减压治疗腰椎融合术后邻近节段疾病能够获得较好的临床疗效。
Objective To analyze the clinical efficacy of percutaneous endoscopic decompression for adjacent segment diseases after lumbar fusion surgery.Methods A total of 26 patients with adjacent segment diseases after lumbar fusion surgery undergoing percutaneous endoscopy decompression in our hospital from January 2020 to June 2022 were retrospectively analyzed.The patients were operated through transforaminal approach in 11 cases and translaminar approach in 15 cases.There were 21 cases of unilateral decompression and 5 cases bilateral decompression.The clinical efficacy were evaluated by using the Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),Japanese Orthopedic Association(JOA)scores,and modified MacNab criteria.Results All the operations were completed successfully without serious complications.The operative time was(85.4±21.7)min,the blood loss was(19.8±5.9)ml,and the number of intraoperative fluoroscopy was(7.7±2.4)times.The VAS scores of lower limb pain were significantly decreased immediately after operation(P=0.000).The patients were followed up for 10-24 months postoperatively,with an average of(16.0±3.7)months.At 3 months after operation and at the last follow-up,the VAS scores and ODI were significantly reduced compared to before surgery(F=105.444,P=0.000;F=852.714,P=0.000),while the JOA scores were significantly increased(F=256.222,P=0.000).At the last follow-up,the efficacy was excellent in 18 cases(69.2%),good in 5 cases(19.2%),and fair in 3 cases(11.5%),with an overall excellent and good rate of 88.5%(23/26).Conclusion Percutaneous endoscopic treatment of adjacent segment diseases after lumbar fusion can achieve good clinical efficacy.
作者
张树文
地力木拉提·艾克热木
王浩
Zhang Shuwen;Dilimulati Aikeremu;Wang Hao(Department of Spine Surgery,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2024年第4期255-260,共6页
Chinese Journal of Minimally Invasive Surgery
基金
新疆“天池英才”引进计划(XJTCYC2023001)。
关键词
经皮内镜技术
邻近节段退变
邻近节段疾病
Percutaneous endoscopy
Adjacent segment degeneration
Adjacent segment disease
