摘要
[目的]比较Endo-Surgi Plus脊柱内镜单侧入路双侧减压技术(endoscopic unilateral laminotomy and bilateral decompression,Endo-ULBD)与开放双侧减压治疗老年腰椎管狭窄症患者的临床疗效。[方法]2018年12月—2020年12月在本院手术治疗的51例腰椎管狭窄症患者纳入本研究,根据医患沟通结果,将患者分为内镜组(31例),开放组(20例)。比较两组临床和影像结果。[结果]所有患者均顺利完成手术,内镜组手术时间[(73.2±21.0)min vs(178.4±22.9)min,P<0.001]、术中出血量[(7.1±3.6)ml vs(220.0±140.9)ml,P<0.001]、术后下地时间[(1.5±0.4)d vs(6.4±1.8)d,P<0.001]、住院时间[(3.0±1.2)d vs(9.4±3.1)d,P<0.001]均显著少于开放组。随时间推移,两组腰痛、腿痛VAS评分、ODI评分均显著改善(P<0.05),相应时间点,两组间上述指标的差异均无统计学意义(P>0.05)。末次随访两组MacNab优良率的差异无统计学意义(P>0.05)。与术前相比,末次随访时,两组椎间隙高度无显著变化(P>0.05),硬膜囊横截面积显著增加(P<0.05)。相应时间点,两组间上述影像指标的差异均无统计学意义(P>0.05)。[结论]Endo-ULBD治疗老年腰椎管狭窄症,具有安全、微创、康复快等优点,且疗效与开放手术相当,短期临床疗效好。
[Objective]To compare the clinical outcomes of endoscopic unilateral laminotomy and bilateral decompression(EndoULBD)with Endo-Surgi Plus endoscope versus open bilateral decompression for lumbar spinal stenosis in the elderly.[Methods]A retrospective study was done on 51 patients who received surgical treatment for lumbar spinal stenosis in our hospital from December 2018 to December 2020.According to the doctor-patient communication,31 patients underwent the endoscopic decompression,while other 20 patients had the conventional open decompression.The clinical and imaging data were compared between the two groups.[Results]All patients in both groups had operation performed successfully.The endoscopic group was significantly superior to the open group in terms of operation time[(73.2±21.0)min vs(178.4±22.9)min,P<0.001],intraoperative blood loss[(7.1±3.6)ml vs(220.0±140.9)ml,P<0.001],postoperative bed rest time[(1.5±0.4)days vs(6.4±1.8)days,P<0.001],and hospital stay[(3.0±1.2)days vs(9.4±3.1)days,P<0.001].As time went by,the VAS scores of low back pain and leg pain,as well as ODI score in the two groups were significantly improved(P<0.05),which were not statistically significant between the two groups at any corresponding time points(P>0.05).At the last follow-up,there was no significant difference in MacNab excellent and good rate between the two groups(P>0.05).At the last follow-up,there was no significant change in vertebral space height(P>0.05),while the dural sac cross-sectional area was significantly increased in both groups compared with those before operation(P<0.05).At corresponding time points,there were no significant differences in the above image indicators between the two groups(P>0.05).[Conclusion]The Endo-ULBD achieve good short-term clinical consequence comparable to the open surgery,while has the advantages of minimally invasive surgery and rapid recovery for lumbar spinal stenosis in the elderly.
作者
汤玮
丁兆利
潘伟
韩庆龙
周东生
TANG Wei;DING Zhao-li;PAN Wei;HAN Qing-long;ZHOU Dong-sheng(Department of Orthopedics,The Second People's Hospital of Rizhao City,Rizhao,Shandong 276807,China;Department of Orthopaedics,Shandong Provincial Hospital,Jinan,Shandong 250000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2024年第16期1520-1524,共5页
Orthopedic Journal of China
