可视化椎间孔两次成形术治疗腰椎侧隐窝狭窄的临床疗效与安全性分析  

Clinical efficacy and safety of visual foramina double-plasty for lumbar lateral recess stenosis

作　　者：贾忠雄 张晓军[1] 胡侦明[1] 江维[1] 沈皆亮[1] 周年[1] 郝杰[1] JIA Zhong-xiong;ZHANG Xiao-jun;HU Zhen-ming;JIANG Wei;SHEN Jie-liang;ZHOU Nian;HAO Jie(Department of Orthopedic Surgery,The First Affiliated Hospital,Chongqing Medical University,Chongqing,400016,China)

机构地区：[1]重庆医科大学附属第一医院骨科,400016

出　　处：《中国骨与关节杂志》2021年第10期777-780,共4页Chinese Journal of Bone and Joint

基　　金：重庆市自然科学基金(cstc2018jcyjAX0797)。

摘　　要：目的评估可视化椎间孔两次成形术治疗腰椎侧隐窝狭窄的临床疗效与安全性。方法回顾性收集2018年1月至2019年1月,因腰椎侧隐窝狭窄于我院接受可视化椎间孔两次成形术治疗的58例患者的临床资料,其中男30例,女28例,年龄(49.29±13.03)岁,L4~531例,L5~S127例。采用疼痛视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(oswestry disability index,ODI)评价临床疗效。末次随访时采用MacNab标准对手术临床疗效进行评价。结果58例手术均顺利完成,术中无硬膜囊撕裂、神经根损伤、高颅压等并发症发生,术后无切口不愈合、感染等并发症发生。手术时间平均为(108.33±9.82)min,手术切口长度(1.08±0.18)cm,住院时间(3.93±1.18)天。本组随访时间6~11个月,平均(8.43±1.71)个月。患者术前的腰部VAS评分、下肢VAS评分、ODI分别为(2.22±1.06)、(6.66±1.07)和(71.34±10.23),与末次随访时的(0.10±0.31)、(0.18±0.38)和(0.48±1.01)比较,差异有统计学意义(P<0.05)。末次随访时采用改良MacNab标准对手术疗效进行评价,优良率为89.66%。结论可视化椎间孔两次成形术治疗腰椎侧隐窝狭窄具有创伤小、住院时间短、疗效确切等优点。Objective To evaluate the clinical efficacy and safety of visual foramina double-plasty in the treatment of lumbar lateral recess stenosis.Methods From January 2018 to January 2019,clinical data of 58 patients with lumbar lateral recess stenosis were retrospectively analyzed.All(L4-5 in 31 cases;L5-S1 in 27 cases)received foramina double-plasty in our hospital,including 30 males and 28 females with an average age of(49.29±13.03)years.VAS and ODI were used to evaluate the clinical efficacy.At the last follow-up,Macnab standard was used to evaluate surgery outcomes.Results All the 58 surgeries were successfully completed.No complications including dural sac tear,nerve root injury or intracranial hypertension occurred during the operation;no complications such as wound nonunion and infection occurred after the operation.The average operation time was(108.33±9.82)min;incision length(1.08±0.18)cm;hospital stay(3.93±1.18)days.The average follow-up was(8.43±1.71)months(range:6-11 months).Lumbar VAS,leg VAS and ODI decreased from(2.22±1.06),(6.66±1.07),(71.34±10.23)preoperatively to(0.10±0.31),(0.18±0.38),(0.48±1.01)postoperatively(P<0.05).At the last follow-up,modified Macnab standard was used to evaluate the surgical efficacy,and the excellent and good rate was 89.66%.Conclusions Visual foramina double-plasty has the advantages of less trauma,shorter hospital stay and confirmed effect in the treatment of lumbar lateral recess stenosis.

关 键 词：脊柱疾病 腰椎 最小侵入性外科手术 治疗结果 

分 类 号：R681.5[医药卫生—骨科学]