两种入路手术治疗腰椎管狭窄症的疗效比较  

Comparison of effects of two approaches surgical treatment for lumbar spinal canal stenosis

作　　者：厉彦成 邹向南 李磊[1] 刘延晓 饶建伟 叶舟 王华[1] LI Yan-cheng;ZOU Xiang-nan;LI Lei;LIU Yan-xiao;RAO Jian-wei;YE Zhou;WANG Hua(Dept of Orthopaedics,Quzhou Hospital Affiliated of Wenzhou Medical University,the People′s Hospital of Quzhou City,Quzhou,Zhejiang 324000,China)

机构地区：[1]温州医科大学附属衢州医院(衢州市人民医院)骨科,浙江衢州324000 [2]衢州市柯城区人民医院骨科,浙江衢州324003

出　　处：《临床骨科杂志》2023年第3期318-322,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较单侧双通道入路间盘切除术(UBED)与经皮内镜椎板间入路间盘切除术(PEID)治疗腰椎管狭窄症的临床疗效。方法将手术治疗的46例腰椎管狭窄症患者根据入路方式不同分为UBED组(25例)和PEID组(21例)。比较两组腰背痛VAS评分、下肢痛VAS评分、腰椎JOA评分以及手术责任节段椎管横截面面积。结果患者均获得随访,时间3~5个月。腰背痛VAS评分:术后1个月PEID组低于UBED组(P<0.001),术后3个月两组比较差异无统计学意义(P>0.05)。下肢痛VAS评分、腰椎JOA评分:两组术后1、3个月比较差异均无统计学意义(P>0.05)。术后手术责任节段椎管横截面面积及椎管改善率:UBED组均优于PEID组(P<0.05)。结论相较于PEID,UBED治疗腰椎管狭窄症具有减压范围广、椎管改善好的优点。Objective To compare the clinical efficacy of unilateral biportal endoscopic discectomy(UBED)and percutaneous endoscopic interlaminar discectomy(PEID)for lumbar spinal stenosis.Methods The 46 patients with lumbar spinal stenoses were divided into UBED group(25 cases)and PEID group(21 cases)according to different approaches.The pain VAS of low back and lower limbs,lumbar JOA score and the cross-sectional area of vertebral canal at the responsible segment between the two groups were compared.Results All patients were followed up for 3~5 months.Pain VAS of low back:at 1 month after operation,PEID group was lower than UBED group(P<0.01),and there was no significant difference between the two groups at 3 months after operation(P>0.05).Pain VAS of lower limbs and JOA score of lumbar spine:there were no significant differences between the two groups at 1,3 months after operation(P>0.05).At the postoperation,UBED group was better than PEID group in the cross-sectional area and improvement rate of vertebral canal at the responsible segment(P<0.05).Conclusions Compared with PEID,UBED has the advantages of wide decompression range and good improvement of spinal canal area in the treatment of lumbar spinal stenosis.

关 键 词：单侧双通道入路 经皮内镜椎板间入路 腰椎管狭窄 椎间盘切除术 

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