单侧开窗跨顶减压术治疗腰椎管狭窄症的临床疗效  

fenestration with over-the-top spinal decompression for treatment of lumbar spinal stenosis

作　　者：卢明毅 覃海飚[2] 陈勇喜[2] 许建文[3] 陈建泉 LU Ming-yi;QIN Hai-biao;CHEN Yong-xi;XU Jian-wen;CHEN Jian-quan(The First Clinical College,Guangxi University of Chinese Medicine,Nanning 530001,China;The First Department of Orthopedics,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530003,China;Department of Rehabilitation Medicine,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西中医药大学第一临床医学院,南宁市530023 [2]广西中医药大学第一附属医院骨一科,南宁市530003 [3]广西医科大学第一附属医院康复医学科,南宁市530021

出　　处：《广西医学》2020年第24期3179-3182,共4页Guangxi Medical Journal

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2017042)。

摘　　要：目的观察单侧开窗跨顶减压术治疗腰椎狭窄症(LSS)的临床疗效及安全性。方法将60例LSS患者,随机分成观察组与对照组,各30例。观察组采用单侧开窗跨顶减压术治疗,对照组采用双侧椎板开窗减压术治疗。比较两组患者术中出血量、手术时间、术后住院时间、术后并发症的发生率,以及治疗前后日本骨科协会(JOA)评分、Oswestry功能障碍指数(ODI)。结果观察组术中出血量、手术时间及术后住院时间均少于或短于对照组(均P<0.05),两组术后并发症的发生率差异无统计学意义(P>0.05)。观察组在术后第1个月、6个月、12个月的JOA评分与ODI均优于对照组(均P<0.05)。结论单侧开窗跨顶减压术治疗LSS疗效确切,与双侧椎板开窗减压术相比,可更好地改善患者腰椎功能,具有术中出血量少、手术时间短、术后住院时间短的优点。Objective To observe the clinical efficacy and safety of unilateral fenestration with over-the-top spinal decompression for treating lumbar spinal stenosis(LSS).Methods Sixty LSS patients were randomly divided into observation group and control group,with 30 cases in each group.The observation group was treated with unilateral fenestration with over-the-top spinal decompression,while the control group was treated with bilateral fenestration laminectomy and spinal decompression.Intraoperative blood loss,operation duration,postoperative hospital stay,incidence rate of postoperative complications,as well as the Japanese Orthopaedic Association(JOA)scores and the Oswestry disability index(ODI)before and after treatment were compared between the two groups.Results The observation group had less intraoperative blood loss,shorter operation duration and postoperative hospital stay than the control group(all P<0.05),and there was no statistically significant difference in incidence rate of postoperative complications between the two groups(P>0.05).The observation group was superior to the control group in terms of JOA scores and ODI in the first,6th and 12th month after operation(all P<0.05).Conclusion Unilateral fenestration with over-the-top spinal decompression has a definite efficacy for LSS,which can better improve patients′lumbar function as compared with bilateral fenestration laminectomy and spinal decompression,with the advantages of less intraoperative blood loss,short operation duration and short postoperative hospital stay.

关 键 词：腰椎管狭窄症 单侧开窗跨顶减压术 双侧椎板开窗减压术 疗效 并发症 

分 类 号：R681.533.2[医药卫生—骨科学]