经皮椎间孔镜技术治疗老年退变性腰椎管狭窄症的临床研究  

PERCUTANEOUS TRANSFORAMINAL APPROACH SPINAL ENDOSCOPy FOR TREATMENT OF DEGENERATIVE LUMBAR SPINAL STENOSIS

作　　者：陈付强[1] 于洋[1] 杨文荣[1] 谢平[1] 孙明洁[1] 王昕[1] 

机构地区：[1]青岛市市立医院疼痛科,青岛266011

出　　处：《中国疼痛医学杂志》2015年第10期759-763,共5页Chinese Journal of Pain Medicine

基　　金：青岛市市南区立项课题(2014-14-028-YY);青岛市卫计委立项课题(2014-WJZD049)

摘　　要：目的:观察经皮椎间孔镜技术治疗退变性腰椎管狭窄症的临床疗效与安全性。方法:退变性腰椎管狭窄症患者40例,采用经皮椎间孔入路脊柱内镜技术行病变处"椎管扩大成形术+椎间盘髓核摘除术+神经根松解术",于治疗前和治疗结束时、3个月、6个月时采用(visual analogue scale,VAS)评分评估疼痛程度,JOA评估治疗分数,并观察治疗前后临床体征变化。结果:根据Mac Nab疗效评定的标准,分为优秀,良好,一般和差,随访6个月结果显示,优秀、良好、一般、差率依次为60.0%(24/40例),35%(14/40例),5.0%(2/40例),0.0%(0/40例);与治疗前比较,治疗后各时点VAS及JOA评分有明显改善,差异有统计学意义(P<0.05);与治疗结束时比较,同组治疗后3、6个月时VAS评分,JOA总评分差异均无统计学意义。结论:经皮椎间孔镜技术治疗退变性腰椎管狭窄症是一种微创、有效的方法。Objective： To evaluate the effect of percutaneous transforaminal approach spinal endoscopy in the treatment of degenerative lumbar spinal stenosis. Methods： 40 patients with degenerative lumbar spinal stenosis was selected. These patients had undergone the percutaneous transforaminal approach spinal endoscopy for spine canal enlarged and discectomy as well as relax the nerve. The preoperative and postoperative visual analogue scale（VAS） were used to assess the intensity of pain. The Japanese Orthopaedic Association Scores（JOA） was performed to assess treatment effect. Clinical signs of change were observed before and after treatment. The results were categorized as excellent, good, fair, and poor according to Mac Nab＇s criteria. Result： As per Mac Nab＇s criteria 24 patients（60.0%） showed excellent, 14（35.0%） good, 2（5%） fair, and 0（0%） poor results. Our results show that the percutaneous transforaminal approach spinal endoscopy in the treatment of degenerative lumbar spinal stenosis can significantly improve the VAS and JOA score at each time point after treatment when compared with preoperation（P〈0.05）. There was no significant difference in the VAS and JOA total score at each time point after treatment when compared with immediate postoperative. Conclusion： Percutaneous transforaminal approach spinal endoscopy is a safe and efficacious minimally invasive therapy technique for treatment of degenerative lumbar spinal stenosis.

关 键 词：椎间孔镜技术 退变性腰椎管狭窄症 微创疗法 

分 类 号：R687.3[医药卫生—骨科学]