脊柱内镜下融合技术治疗退行性腰椎疾病的早期疗效  

Early effects of spinal endoscopic fusion technology in the treatment of degenerative lumbar disease

作　　者：王放[1] 王永虎 乔浩 刘东藩 郭栋 王瑞[1] 王栋[1] 李浩鹏[1] 李锋涛[1] WANG Fang;WANG Yonghu;QIAO Hao;LIU Dongfan;GUO Dong;WANG Rui;WANG Dong;LI Haopeng;LI Fengtao(The Second Department of Orthopedics,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004;Department of Orthopedics,The Second People’s Hospital of Xining,Xining 810003,China)

机构地区：[1]西安交通大学第二附属医院骨二科,陕西西安710004 [2]西宁市第二人民医院骨科,青海西宁810003

出　　处：《西安交通大学学报（医学版）》2022年第1期143-148,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金(No.81701223);陕西省自然科学基金(No.2021JM-290)。

摘　　要：目的报道脊柱内镜下融合技术(Endo-LIF)治疗退行性腰椎疾病的早期临床效果和手术并发症。方法回顾分析自2019年5月至2021年5月本院31例行Endo-LIF治疗的退行性腰椎疾病患者的临床资料,31例均行脊柱内镜镜下融合治疗。记录其手术时间、住院时间及术后并发症发生情况,术前、术后即刻及末次随访的疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)以及中华骨科学会脊柱学组腰背痛手术评分标准评价临床疗效。结果31例患者手术时间为(134.80±34.98)min,术中出血量(100.13±18.49)mL,住院时间(6.65±0.17)d,随访时间6~18(14±2.3)个月。其中1例患者术后发生血肿压迫,立即切开清除血肿后痊愈;2例患者发生类脊髓高压症,卧床休息后痊愈。术后所有患者均无神经损伤症状,临床症状明显缓解。31例患者围术期VAS评分、ODI指数比较,术后即刻及末次随访较术前均降低(P<0.05),差异有统计学意义。结论Endo-LIF术短期临床效果好,具有创伤小、出血量小、术后恢复快等优点,是一种安全微创的腰椎融合术。Objective To report the early clinical effects and surgical complications of endoscopic spinal fusion technology(Endo-LIF)in the treatment of degenerative lumbar disease.Methods The clinical data of 31 patients with degenerative lumbar spine disease treated with Endo-LIF from June 2019 to May 2021 were retrospectively analyzed.All the 31 patients underwent endoscopic spinal fusion therapy.We recorded the operation time,hospital stay duration,postoperative complications,visual analogue scale for pain(VAS),oswestry dysfunction Index(ODI)and low back pain in the Chinese Orthopaedic Association Spine Group Surgery scoring standards before operation,immediately after operation,and the last follow-up to evaluate clinical efficacy.Results The operation time of the 31 patients was(134.80±34.98)min,the intraoperative blood loss was(100.13±18.49)mL,the hospital stay was(6.65±0.17)days,and the follow-up time was 6 to 18(14±2.3)months.One patient had hematoma compression after surgery;he had incision made immediately to clear the hematoma and healed after bed rest.Two patients developed spinal hypertension and healed after bed rest.All the patients had no symptoms of nerve injury after operation,and the clinical symptoms were significantly relieved.We compared the perioperative VAS score and ODI index of all the patients,which were lower immediately after operation and at the last follow-up than those before the operation(P<0.05),and the difference was statistically significant.Conclusion Endo-LIF technology has good short-term clinical effects and the advantages of milder trauma,less blood loss,and quick recovery after surgery.It is a safe and minimally invasive lumbar fusion surgery.

关 键 词：退行性腰椎疾病 脊柱内镜 镜下融合 Endo-LIF 

分 类 号：R681.5[医药卫生—骨科学]