椎间孔镜治疗多节段腰椎神经根管狭窄的中长期随访  

Mid-long term clinical outcomes of transforaminal endoscopic decompression of multi-segment lumbar nerve root canal stenosis

作　　者：常峰 高刚 于晨 胡兆林 张挺 CHANG Feng;GAO Gang;YU Chen;HU Zhao-lin;ZHANG Ting(Department of Orthopedics,Peopled Hospital,Shanxi Medical University,Taiyuan,030012,China)

机构地区：[1]山西医科大学附属人民医院骨科,山西太原030012

出　　处：《中国矫形外科杂志》2021年第23期2140-2143,共4页Orthopedic Journal of China

摘　　要：[目的]总结经皮椎间孔镜技术治疗多节段腰椎神经根管狭窄症的临床疗效。[方法]回顾性分析2012年2月一2015年5月本院采用经皮椎间孔镜技术对神经根管出入口区域实施减压和神经根松解治疗神经根管狭窄症364例患者的临床资料,对围手术期、随访与影像资料进行总结。[结果]所有患者顺利完成手术,术中均未发生严重并发症,平均手术时间(57.62±8.31)min,平均术中出血量(9.28±2.53)ml,平均住院时间(4.52±1.63)d。所有患者获得随访,平均随访时间(5.71±0.63)年。随时间推移,患者VAS和ODI评分显著降低(P<0.05),而JOA评分显著增加(P<0.05)。根据MacNab评级标准,末次随访时,优273例,良77例,可14例,优良率为96.15%。影像方面,与术前相比,术后各吋间点骨性侧隐窝角和软性侧隐窝角均显著增大(P<0.05);术后各时间点相比,骨性侧隐窝角和软性侧隐窝角均无显著改变(P>0.05)。[结论]本研究5年随访结果表明,经皮椎间孔镜技术治疗多节段腰椎管狭窄症效果可靠,是一种安全的术式。[Objective]To summarize the mid-long term of clinical outcomes of transforaminal endoscopic decompression of multi-segment lumbar nerve root canal stenosis.[Methods]A retrospective study was conducted on 364 patients who received transforaminal endoscopic decompression and nerve release for multi-segment lumbar nerve root canal stenosis from February 2014 to May 2015.The documents of perioperative period,follow-up and radiographs were summarized.[Results]All the patients had operation completed successfully with operation time of(57.62±8.31)min,intraoperative blood loss of(9.28±2.53)ml,and the average hospital stay of(4.52±1.63)days,whereas without serious complications.All patients were followed up for an average of(5.71±0.63)years.As time went,the VAS and ODI scores significantly decreased(P<0.05),whereas the JOA score significantly increased(P<0.05).Based on Macnab's criteria,the clinical outcomes was graded as excellent in 273 patients,good in 77 and fair in 14,with the excellent and good rate of 96.15%.In term of radiographic evaluation,the bony and soft lateral recess angles significantly increased at all time point postoperatively compared with those before operation(P<0.05),and remained unchanged among time points postoperatively(P>0.05).[Conclusion]As results of this study with the more than 5-year follow up,the transforaminal endoscopic decompression combined with nerve root release is an effective and safe treatment for multi-segment lumbar nerve root canal stenosis.

关 键 词：腰椎神经根管狭窄症 经皮椎间孔镜 神经松解术 中长期随访 

分 类 号：R687[医药卫生—骨科学]