超声骨刀应用于腰椎管狭窄症后路腰椎椎间融合术中对腰椎管狭窄症患者疼痛程度及ODI的影响  

Effect of Ultrasonic Osteotome on Pain and ODI Index of Patients with Lumbar Spinal Stenosis Undergoing Posterior Lumbar Interbody Fusion

作　　者：林艺靖 LIN Yijing(The Second Affi liated Hospital of Xiamen Medical College,Xiamen 361021,China)

机构地区：[1]厦门医学院附属第二医院,福建厦门361021

出　　处：《中国医药指南》2020年第30期37-38,共2页Guide of China Medicine

摘　　要：目的研究在对腰椎管狭窄症患者行腰椎管狭窄症后路腰椎椎间融合术过程中应用超声骨刀辅助治疗对患者的疼痛程度及功能障碍指数(ODI)的影响。方法选择2016年9月至2019年1月我院收入治疗的腰椎狭窄症患者78例,对其资料进行回顾性分析,按照术中使用骨刀的不同将其分为超声组(38例,在术中行超声骨刀对其腰椎椎板显露神经根、硬膜囊切除)与普通组(40例,在术中行普通骨刀等传统医疗器械)。对比分析患者术后1周、12周及24周时的疼痛程度(采用VAS法评价)变化及24周时的ODI评分。结果两组患者术前ODI及VAS指标均无明显差异(P>0.05);术后1周,两组患者VAS指标对比无明显差异(P>0.05);术后12周及24周,超声组患者VAS指标明显低于普通组,且两组患者评分每一时间点较上一时间点均有明显变化,差异均具有统计学意义(P<0.05);术后24周,超声组患者ODI明显低于普通组,且两组患者术后评分较术前均有明显变化,差异均具有统计学意义(P<0.05)。结论对腰椎管狭窄症患者行腰椎管狭窄症后路腰椎椎间融合术,术中行超声骨刀相较于普通骨刀,对患者的预后作用更佳,具有可行性。Objective To study the eff ect of ultrasound osteotome on the pain degree and dysfunction index(ODI)of patients with lumbar spinal stenosis during posterior lumbar interbody fusion for lumbar spinal stenosis.Methods A total of 78 patients with lumbar spine stenosis treated in our hospital from September 2016 to January 2019 were selected.Their data were retrospectively analyzed,and they were divided into ultrasound groups(38 patients,during the operation,the ultrasonic bone knife was used to expose the nerve roots of the lumbar vertebral lamina,and the dural sac was removed)and the normal group(40 cases,with traditional medical equipment such as common bone knife during the operation).The changes in the degree of pain(assessed by the VAS method)at 1 week,12 weeks and 24 weeks after the operation and the ODI score at 24 weeks were compared and analyzed.Results There was no signifi cant diff erence in ODI and VAS indexes between the two groups before operation(P>0.05);1 week after operation,there was no signifi cant diff erence in VAS indexes between the two groups(P>0.05);12 weeks and 24 weeks after operation,ultrasound group the VAS index of patients was signifi cantly lower than that of the ordinary group,and the scores of the two groups of patients were signifi cantly changed at each time point compared with the previous time point,and the diff erences were statistically signifi cant(P<0.05);24 weeks after surgery,patients in the ultrasound group had signifi cant ODI was lower than that of the normal group,and the scores of the two groups of patients after surgery were signifi cantly changed compared with that before surgery,and the diff erences were statistically signifi cant(P<0.05).Conclusion In patients with lumbar spinal stenosis,posterior lumbar interbody fusion for lumbar spinal stenosis,intraoperative ultrasonic osteotome has better prognostic eff ect on patients than ordinary osteotome and is feasible.

关 键 词：腰椎管狭窄症 后路腰椎椎间融合术 超声骨刀 疼痛程度 ODI 

分 类 号：R681.5[医药卫生—骨科学]