DELTA内镜下单侧入路双侧减压治疗腰椎椎管狭窄症的疗效分析  

Analysis of the efficacy of unilateral approach and bilateral decompression under DELTAendoscope in the treatment of lumbar spinal stenosis

作　　者：宋雨珂 苏国义[2] 李永津[2] 王羽丰[2] SONG Yu-ke;SU Guo-yi;LI Yong-jin;WANG Yu-feng(The Third Affiliated Hospital of Guangzhou University of traditional Chinese medicine,Guangzhou,Guangdong 510378;Department of Orthopedics,Traditional Chinese Medicine Hospital of Guangdong Province,Guangzhou,Guangdong 510030,China)

机构地区：[1]广州中医药大学第三附属医院,广东广州510378 [2]广东省中医院骨一科,广东广州510030

出　　处：《颈腰痛杂志》2022年第1期33-36,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨DELTA内镜下单侧入路双侧减压治疗单节段腰椎管狭窄症的临床疗效。方法选取广东省中医院骨科自2018年1月~2019年6月手术治疗的60例单节段腰椎管狭窄症患者,根据手术方式不同分为DELTA组和MIS-TLIF组,DELTA组采用DELTA内镜下单侧椎板间入路双侧减压术治疗,MIS-TLIF组采用微创管道下单侧入路双侧减压椎间植骨融合术治疗。比较两组患者手术时间、出血量、切口长度和住院时间,根据患者术前、术后第2天、术后3个月、术后半年随访时的下腰痛VAS评分、腰椎JOA评分评估疼痛及腰椎功能改善情况,并根据末次随访时改良MacNab标准评估术后疗效。结果DELTA组在手术时间、术中出血量、切口长度以及住院天数方面显著优于MIS-TLIF组,差异有统计学意义(P<0.05)。两组患者术后各时间段下腰痛VAS评分、腰椎JOA评分较术前均有明显下降,差异有统计学意义(P<0.05);两组术后下腰痛VAS评分、腰椎JOA评分的相同时间点组间比较,DELTA组明显优于MIS-TLIF组,差异有统计学意义(P<0.05);两组患者末次随访时改良MacNab疗效差异无统计学意义(P>0.05)。结论DELTA内镜下单侧入路双侧减压治疗单节段腰椎管狭窄症疗效显著,具有创伤小、手术时间短、恢复快等优势,适宜临床应用。Objective To explore the clinical effect of unilateral approach and bilateral decompression under DELTA endoscope in the treatment of single-segment lumbar spinal stenosis,and provide reference for the clinical treatment of lumbar spinal stenosis.Methods A total of 60 patients with single-segment lumbar spinal stenosis admitted to the orthopedics department of Guangdong Hospital of Traditional Chinese Medicine from January 2018 to June 2019 were selected.According to different surgical methods,they were divided into the DELTA group and the MIS-TLIF group.The DELTA group was treated with bilateral decompression via a unilateral interlaminar approach under DELTA endoscope,the MIS-TLIF group was treated with unilateral approach and bilateral decompression intervertebral bone graft fusion under minimally invasive catheter.The operation time,blood loss,incision length and hospital stay of patients in the two groups were compared.Pain and lumbar function improvement was evaluated according to VAS score of low back pain and lumbar JOA score of patients in different time periods before and after surgery,and the postoperative efficacy was evaluated according to the modified MacNab standard at the last follow-up.Results The operation time,intraoperative blood loss,incision length and length of hospital stay in the DELTA group were significantly better than those in the MIS-TLIF group,with statistically significant differences(P<0.05).The lower back pain VAS score and lumbar spine JOA score of the two groups were significantly lower than before surgery,and the differences were statistically significant(P<0.05).VAS scores of low back pain and lumbar JOA scores of the two groups were compared at the same time after surgery,those of the DELTA group were significantly better than the MIS-TLIF group,with statistically significant differences(P<0.05).There was no significant difference in the efficacy evaluation of improved MacNab between the two groups at the last follow-up(P>0.05).Conclusion The unilateral approach and bilatera

关 键 词：DELTA内镜 腰椎管狭窄 双侧减压 微创 

分 类 号：R687.3[医药卫生—骨科学]