经皮椎间孔入路TESSYS技术与小切口开窗术治疗单节段腰椎侧隐窝狭窄分析  

Analysis on Percutaneous Transforaminal TESSYS Technique and Small Incision Fenestration in the Treatment of Single-segment Lumbar Lateral Recess Stenosis

作　　者：马晓虎 赵浩森 杨宇 张会久 Ma Xiaohu;Zhao Haosen;Yang Yu;Zhang Huijiu(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121000

出　　处：《锦州医科大学学报》2023年第2期74-79,共6页Journal of Jinzhou Medical University

基　　金：辽宁省教育厅课题青年项目,项目编号:LJKQZ20222390;辽宁省教育厅2022年基础医学一流学科建设项目,项目编号:JYTMSZR2021020。

摘　　要：目的 分析对比经皮椎间孔入路椎间孔镜技术(transforaminal endoscopic spine system, TESSYS)与小切口开窗术治疗单节段腰椎侧隐窝狭窄疾病的术后疗效。方法 回顾性分析2017年4月至2020年8月锦州医科大学附属第三医院诊治的50例单节段腰椎侧隐窝狭窄疾病患者作为研究对象。根据患者意愿选择手术方式,将其分为TESSYS组及传统组。对比两组患者的手术切口长度、术中出血量、手术时间、卧床时间、并发症出现状况;术前、术后第1天、术后第3个月、第6个月对患者临床表现采取Oswestry功能障碍指数(oswestry disability index, ODI)、疼痛视觉模拟评分(visual analogue scale, VAS)以及末次随访时追加“改良MacNab评定标准”对疗效进行判断。结果 50例患者均获得超过6个月的有效随访。两组患者在性别、年龄、BMI、病史、病变椎体节段的一般资料方面,差异无统计学意义(P>0.05)。TESSYS组的手术切口长度、术中出血量、手术时间、卧床时间方面明显优于传统组(P<0.05)。TESSYS组的术后并发症发生率低于传统组(P<0.05)。两组患者术前ODI功能指数及VAS疼痛评分差异无统计学意义(P>0.05)。术后第1天,术后第3个月、第6个月的ODI指数及VAS疼痛评分均明显好转(P<0.01)。两组术后第6个月ODI差异无统计学意义(P>0.05),其余TESSYS组优于传统组(P<0.01)。TESSYS组的优良率略好于传统组,差异无统计学意义(P>0.05)。结论 经皮椎间孔入路TESSYS技术治疗单节段腰椎侧隐窝狭窄疾病具有损伤更小、恢复更快、高效安全等优点,该技术可减轻患者病痛并提高患者生活质量,具备一定临床价值,值得临床学习及推广。Objective To analyze and compare the postoperative efficacy of percutaneous transforaminal TESSYS technique and small incision fenestration in the treatment of single-segment lumbar lateral recess stenosis.Methods The clinical data of 50 patients with single-segment lumbar lateral recess stenosis treated in the Third Affiliated Hospital of Jinzhou Medical University from April 2017 to August 2020 were retrospectively analyzed.According to the patients'wishes,they were divided into TESSYS group and traditional group.The length of incision,intraoperative blood loss,operation time,bed time,and complications were compared between the two groups;oswestry disability index(ODI)and Visual Analogue Scale(VAS)were used to evaluate the oswestry disability index(ODI)and VAS score before operation,1 day,3 months and 6 months after operation.(VAS)and modified MacNab criteria were added to evaluate the effectiveness at last follow-up.Results All 50 patients were followed up for more than 6 months.There was no significant difference in gender,age,BMI,medical history,and general data of diseased vertebral segments between the two groups(P>0.05).The incision length,intraoperative blood loss,operation time and bed time in the TESSYS group were significantly better than those in the traditional group(P<0.05).The incidence of postoperative complications in the TESSYS group was lower than that in the traditional group(P<0.05).There was no significant difference in ODI and VAS scores between the two groups before operation(P>0.05).The ODI and VAS scores were significantly improved at 1 day,3 months and 6 months after operation(P<0.01).There was no significant difference in ODI between the two groups at 6 months after operation(P>0.05),and the other TESSYS group was better than the traditional group(P<0.01).The excellent and good rate of TESSYS group was slightly better than that of traditional group,but the difference was not statistically significant(P>0.05).Conclusion Percutaneous transforaminal TESSYS technology in the treatment of

关 键 词：单节段 腰椎侧隐窝狭窄疾病 经皮椎间孔入路 TESSYS技术 

分 类 号：R681.5[医药卫生—骨科学]