脊柱内镜可视化技术治疗腰椎侧隐窝狭窄症的近期疗效  

The short-term effect of lumbar lateral recess stenosis treated by spine endoscopic visualization technique

作　　者：孙宜保[1] 杨勇[1] 祝孟坤[1] 代耀军[1] 常晓盼[1] 李毅力 SUN Yi-bao;YANG Yong;ZHU Meng-kun;DAI Yao-jun;CHANG Xiao-pan;LI Yi-li(Dept of Minimally Invasive Spinal Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou,Henan 450052,China)

机构地区：[1]郑州市骨科医院微创脊柱科,河南郑州450052

出　　处：《临床骨科杂志》2021年第3期331-334,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨脊柱内镜可视化椎间孔成形、盘黄间隙扩大术治疗腰椎侧隐窝狭窄症的近期疗效。方法采用脊柱内镜可视化椎间孔成形、盘黄间隙扩大术治疗35例腰椎侧隐窝狭窄症患者。记录手术时间、术中X线透视次数、术后1个月及末次随访时的腰腿痛VAS评分,末次随访时采用MacNab评分标准评价疗效。结果35例均顺利完成手术。手术时间45~85 min,术中X线透视次数5~11次。术中出现硬膜囊撕裂1例,无神经损伤等其他并发症。患者均获得随访,时间3~18个月。术后1例复发,再次行椎间孔镜下摘除复发的髓核组织后症状消失。腰腿痛VAS评分:术后1个月为2~5(2.12±0.26)分,末次随访时为1~4(1.21±0.61)分,与术前5~8(6.12±0.91)分比较差异均有统计学意义(P<0.01)。末次随访时采用MacNab评分标准评价疗效:优15例,良18例,可1例,差1例,优良率94.3%。结论脊柱内镜可视化椎间孔成形、盘黄间隙扩大术治疗腰椎侧隐窝狭窄症可以安全解除侧隐窝神经根压迫,近期疗效满意。Objective To explore the short-term efficacy of endoscopic visualization foraminoplasty,enlarging disc-flava ligament space in the treatment of lumbar lateral recess stenosis.Methods The 35 patients with lumbar lateral recess stenosis were treated by endoscopic visualization foraminoplasty,enlarging disc-flava ligament space.The operation time,intraoperative X-ray fluoroscopy frequency,visual analogue scale(VAS)of lower back and leg pain at 1 month postoperation and the last follow-up were recorded.The clinical effect was assessed with MacNab scoring criterion at the last follow-up.Results All the 35 cases finished surgery smoothly,surgical duration was 45~85 min,the intraoperative X-ray fluoroscopy frequency was 5~11 times.Dural tear occurred in one case,no other complications were found.All cases were followed up for 3~18 months.One case suffered from recurrence postoperatively,and the symptoms disappeared after the operation of the intervertebral foramen again.VAS of lower back and leg pain:they were 2~5(2.12±0.26)scores at 1 month after surgery and 1~4(1.21±0.61)scores at the final follow-up,which were significantly lower than 5~8(6.12±0.91)of the preoperation(P<0.01).At the last follow-up,15 cases were excellent,18 cases were good,and 1 fair,1 poor,with the excellent-good rate of 94.3%,according to the MacNab criteria assessment.Conclusions Endoscopic visualization foraminoplasty,enlarging disc-flava ligament space in the treatment of lumbar lateral recess stenosis can safely relieve the nerve root compression of lateral recess,and the short-term effect is satisfactory.

关 键 词：侧隐窝狭窄 可视化椎间孔成形 盘黄间隙扩大术 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]