脊柱内镜下单侧入路双侧椎管减压术治疗腰椎管狭窄症的早期疗效  

The early-term effect of unilateral spinal endoscopic approach and bilateral spinal canal decompression for the treatment of lumbar spinal stenosis

作　　者：马力[1] 刘艺明[1] 韩国嵩 郑科[1] 祁家龙 裴少保[1] MA Li;LIU Yi-ming;HAN Guo-song;ZHENG Ke;QI Jia-long;PEI Shao-bao(Dept of Spine Surgery,the First People′s Hospital of Hefei,Hefei,Anhui 230061,China)

机构地区：[1]合肥市第一人民医院脊柱外科,安徽合肥230061

出　　处：《临床骨科杂志》2023年第1期19-23,共5页Journal of Clinical Orthopaedics

摘　　要：目的探讨脊柱内镜下单侧入路双侧椎管减压术治疗腰椎管狭窄症的早期疗效。方法采用脊柱内镜下单侧入路双侧椎管减压术治疗26例腰椎管狭窄症患者。记录手术时间、术中出血量,比较手术前后腰腿痛VAS评分、ODI评分、JOA评分,末次随访时采用MacNab标准评价临床疗效。结果手术时间55~105(70±32)min,术中出血量10~20(15±5)ml。患者均获得1个月随访。腰痛及腿痛VAS评分、ODI评分:术后1 d、1个月均低于术前(P<0.05),术后1个月均低于术后1 d(P<0.05)。JOA评分:术后1 d、1个月均高于术前(P<0.05),术后1个月高于术后1 d(P<0.05)。末次随访时采用MacNab标准评价临床疗效:优23例,良2例,中1例,优良率25/26。结论脊柱内镜下单侧入路双侧椎管减压术治疗腰椎管狭窄症早期效果满意,能够改善患者腰腿痛症状,具有创伤小、恢复快等优点。Objective To investigate the early curative effect of unilateral spinal endoscopic approach and bilateral spinal canal decompression in the treatment of lumbar spinal stenosis.Methods The 26 cases of lumbar spinal stenosis were treated with unilateral spinal endoscopic approach and bilateral spinal canal decompression.The operative time and intraoperative blood loss were recorded,and the pain VAS of lower back and leg,ODI scores and JOA scores were compared before and after the operation.The clinical efficacy was evaluated by MacNab evaluation criteria at the last follow-up.Results The operation time was 55~105(70±32)min and the bleeding volume was 10~20(15±5)ml.All patients were followed up for 1 month.Pain VAS of lower back and leg,ODI scores:they were lower at 1 d and 1 month after surgery than before surgery(P<0.05),and which were lower at 1 month after surgery than those at 1 d after surgery(P<0.05).The JOA scores:they were higher at 1 d and 1 month after surgery than the preoperation(P<0.05),and which were higher at 1 month after surgery than those at 1 d postoperation(P<0.05).At the last follow-up,MacNab efficacy evaluation criteria were used to evaluate the curative effect:23 cases were excellent,2 cases were good,1 case fair,and the excellent and good rate was 25/26.Conclusions It has satisfactory early effect that unilateral spinal endoscopic approach and bilateral spinal canal decompression are used to treat lumbar spinal stenosis,which can improve the pain symptoms of lower back and leg,and have the advantages of less trauma and faster recovery.

关 键 词：腰椎管狭窄症 脊柱内镜 单侧入路双侧减压术 

分 类 号：R681.57[医药卫生—骨科学] R687.3[医药卫生—外科学]