内镜下经椎板间入路腰椎减压融合术治疗腰椎滑脱症  

Endoscopic Lumbar Interlaminar Decompression and Fusion for the Treatment of Lumbar Spondylolisthesis

作　　者：李承蔚 李智斐[2] 钟远鸣[2] 黄保华[2] 莫怡[2] 梁渊耀 蒙纪文 梁钦秋 杨尹 

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学第一附属医院,广西南宁530000

出　　处：《大众科技》2023年第9期65-69,33,共6页Popular Science & Technology

基　　金：广西重点研发计划“基于精准医疗模式下多节段腰椎管狭窄症诊治方案规范化及示范研究”(桂科AB20159018)。

摘　　要：目的:探讨内镜下经椎板间入路腰椎减压融合术治疗腰椎滑脱症的临床疗效。方法:采用全内镜下经椎板间入路腰椎减压融合术治疗25例单节段腰椎轻度滑脱的患者。记录手术操作过程、术后并发症等情况,术后1、3、6个月随访时记录腰痛及腿痛VAS评分、椎间隙高度以ODI指数,术后6个月记录椎体滑脱率、滑脱角、JOA评分,对比术前指标以评估疗效。结果:手术时间61~122 min,术中透视5~11次,术中出血量为52~110 mL,术后引流量64~116 mL,术后切口愈合良好,未出现明显感染,术后未出现严重并发症。术后1个月、3个月、末次随访(即术后6个月随访)时的腰痛、腿痛VAS评分均低于术前(P<0.05)。末次随访时所测得的椎体滑脱率、滑脱角以及JOA评分均优于治疗前,各个时间点测得指标同术前指标差异均有统计学意义(P<0.05)。结论:内镜下经椎板间入路腰椎融合术能在较安全的基础上实现充分的神经根减压、椎体间融合,显著改善患者腰椎滑脱所导致的腰腿痛症状及功能障碍,手术疗效较好。Objective:To investigate the clinical effect of endoscopic lumbar interlaminar decompression and fusion in the treatment of lumbar spondylolisthesis.Methods:25 patients with single segmental lumbar spondylolisthesis were treated by total endoscopic lumbar interlaminar decompression and fusion.The operation process and postoperative complications were recorded.VAS scores,intervertebral height and ODI index were recorded for lumbago and leg pain at 1,3 and 6 months after the operation.Vertebral spondylolisthesis rate,spondylolisthesis Angle and JOA score were recorded at 6 months afer the operation.The preoperative indexes were compared to evaluate the curative effect.Results:The operation time was 61 to 122 min,the intraoperative fluoroscopy was 5 to 11 times,the intraoperative blood loss was about 52 to 110mL,the postoperative drainage volume was 64 to 116mL,the postoperative incision healed well,there was no obvious infection,and no serious postoperative complications occurred.The VAS scores of low back pain and leg pain at 1 month,3 months and the last follow-up(6 months after operation)were lower than those before operation(P<0.05).The spondylolisthesis rate,spondylolisthesis angle and JOA score measured at the last follow-up were better than those before treatment,and the differences between the measured indicators at each time point and the preoperative indicators were statistically significant(P<0.05).Conclusion:Endoscopic interlaminar lumbar fusion can achieve sufficient nerve root decompression and interbody fusion on the basis of safety,and significantly improve the symptoms of low back pain and dysfunction caused by lumbar spondylolisthesis in patients,and the surgical effect is good.

关 键 词：腰椎滑脱症 内窥镜 经椎板间入路 腰椎减压融合术 

分 类 号：R68[医药卫生—骨科学]