微创单侧入路双侧减压治疗腰椎椎管狭窄症早期疗效观察  

Preliminary results of minimally invasive bilateral decompression via unilateral approach in the treatment of lumbar canal stenosis

作　　者：吴文坚[1] 梁裕[1] 张兴凯[1] 曹鹏[1] 郑涛[1] 

机构地区：[1]交通大学医学院附属瑞金医院骨科,上海200025

出　　处：《脊柱外科杂志》2012年第3期129-133,共5页Journal of Spinal Surgery

基　　金：上海市卫生局青年科研项目(2008Y061)

摘　　要：目的评估微创单侧入路双侧减压经椎间孔椎体间融合术治疗腰椎椎管狭窄症的短期疗效。方法 2010年6～10月,38例腰椎椎管狭窄症患者接受开放或微创手术治疗,微创组17例,开放组21例。记录手术时间、术中出血量和引流量、术后住院时间、并发症情况以及手术前后的腰痛视觉模拟量表(visual analog scale,VAS)评分及日本骨科学会(Japanese Orthopaedic Association,JOA)评分。结果平均随访7.6个月。微创组平均出血量较少,手术时间较长,而术后住院时间较短。2组患者术后腰痛及功能均有显著改善,微创组末次随访时腰痛VAS评分低于开放组,微创组术后、随访时JOA评分及JOA改善率均明显高于开放组。微创组患者并发症发生率略高于开放组但差异无统计学意义(P>0.05)。结论微创单侧入路双侧减压结合微创经椎间孔椎体间融合术治疗腰椎椎管狭窄症短期疗效满意,其长期疗效有待进一步随访明确。Objective To investigate the clinical results of minimally invasive bilateral decompression via unilateral approach in the treatment of lumbar canal stenosis. Methods From June to October 2010, 38 cases of lumbar canal stenosis were treated with open or minimally invasive surgery. Seventeen cases were treated with minimally invasive surgery （MIS） and 21 cases with open surgery.. The mean operating time, blood loss and drainage volume, postoperative hospitalization, complica- tions, pre- and postoperative scores of visual analog scale （VAS） back pain and Japanese Orthopaedic Association （JOA） were recorded. Results Mean duration of follow-up was 7.6 months. The MIS group had less blood loss, longer operating time and shorter postoperative hospitalization. Baek pain and function of both groups were signifieantly improved ＇after surgery ; the MIS group had less back pain at the final follow-up; the JOA scores and the JOA recovery rate of the MIS group after sur- gery and at the final follow-up were higher than that of the open group. The incidence of complications of MIS group was slightly higher than the open group without significant difference （ P 〈 0.05 ）. Conclusion The preliminary results of mini- mally invasive bilateral decompression via unilateral approach in the treatment of lumbar canal stenosis is satisfactory and fur- ther researeh is needed to determine its long-term results.

关 键 词：腰椎 椎管狭窄 减压术 外科 外科手术 微创性 

分 类 号：R681.533.2[医药卫生—骨科学]