经皮脊柱内镜治疗腰骶椎椎体后缘离断症近期临床观察  

Short-term Clinical Observation of Percutaneous Spinal Endoscopy in the Treatment of Lumbar and Sacral Posterior Edge Amputation

作　　者：唐小松[1] 李越[1] 楚福明[1] 吴忌[1] 王艳杰[1] Tang Xiaosong;Li Yue;Chu Fuming(Sichuan Orthopaedic Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《四川医学》2018年第7期772-775,共4页Sichuan Medical Journal

摘　　要：目的观察经皮脊柱内镜治疗腰骶椎椎体后缘离断症的临床疗效。方法对2016年4月至2017年6月我科收治的29例采用经皮脊柱内镜症状侧单侧(椎间孔或椎板间入路)治疗腰骶椎椎体后缘离断症的患者临床资料进行回顾性研究。结果经过6~18个月的随访,中位时间12个月,VAS评分术前为(5.3±2.1)分,术后6个月为(1.5±1.3)分,差异有统计学意义(P<0.01);ODI评分术前为(76.3±25.9)分,术后6月为(16.9±17.1)分,差异有统计学意义(P<0.01);末次随访时手术疗效满意程度:优25例,良2例,可1例,差1例,优良率为86.2%。结论经皮脊柱内镜治疗腰骶椎椎体后缘离断症具有创伤小、疗效好等优势,值得临床广泛推广;内镜下离断骨块是否完全摘除需根据术前CT三维重建,判定离断骨块稳定性,以神经根或硬膜囊充分减压为目的,并评估完全摘除后对椎间盘纤维环强度影响程度。Objective To observe the clinical effect of percutaneous spinal endoscopy in the treatment of lumbar and sa- cral posterior edge amputation. Methods The clinical data of 29 patients with lumbar and sacral posterior edge amputation treated with unilateral percutaneous endoscopic spinal endoseopes（ intervertebral foramen or interlanfinar approach）in our department from April 2016 to June 2017 were retrospectively studied. Results After 6 - 18 months of follow-up,the median time of 12 months, the VAS score was （5.3 ± 2. 1 ） before operation and （ 1.5 ± 1.3 ） at 6 months after operation, and the deference was statistically sig- nificant（ P 〈 0. 01 ） ; The ODI score was（ 76. 3 ± 25.9） before operation and （ 16.9 ± 17.1 ） at 6 months after operation, statistically significant （ P 〈 0. 01 ） ; At the last follow-up, the satisfactory degree d the operation was excellent in 25 cases, good in 2 eases, fair in1 case and poor in 1 case,and the excellent and good rate was 86. 2%. Conclusion Percutaneous spinal endoscopy in the treatment of lumbar and sacral posterior edge amputation has the advantages of small trauma and good curative effect, which is worthy of exten- sive clinical promotion lThe stability of the broken bone mass should be determined according to the three dimensional reconstruction of CT before operation. The purpose of decompression of nerve root or dural sac is to evaluate the influence of complete excision on the strength of the fibrous ring of intervervebral disc.

关 键 词：椎体后缘离断 经皮脊柱内镜 临床观察 

分 类 号：R681.53[医药卫生—骨科学]