腰椎减压术治疗腰膝综合征的疗效  

Lumbar decompression for lumbo-knee syndrome

作　　者：刘侃 马涉 于栋 顾树明 方心 刘恒平 LIU Kan;MA She;YU Dong;GU Shu-ming;FANG Xin;LIU Hengping(The Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing 100029,China;Beijing University of Chinese Medicine,Beijing100029,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学,北京100029

出　　处：《中国矫形外科杂志》2024年第5期455-458,共4页Orthopedic Journal of China

基　　金：中医骨伤科学一流学科建设项目。

摘　　要：[目的]探讨腰椎减压手术治疗腰膝综合征的临床疗效。[方法]回顾性分析2021年10月—2023年1月腰椎减压治疗35例腰膝综合征患者的临床资料,评价临床及影像结果。[结果]所有患者均顺利完成手术,无脑脊液漏、过敏反应、胃肠道不适等症状出现。全部患者平均随访(5.2±1.6)个月。随术前,术后1周,术后1、3个月的时间推移,患者下肢放射痛VAS评分[(6.2±1.0),(2.4±0.7),(1.1±0.7),(0.5±0.7),P<0.001]、膝关节周围疼痛VAS评分[(5.1±1.1),(2.1±1.1),(1.2±0.7),(0.9±0.9),P<0.001]、WOMAC评分[(51.1±9.5),(31.5±6.6),(16.9±4.0),(10.3±3.7),P<0.001]均显著降低,而JOA评分[(9.2±2.1),(21.3±1.8),(23.5±1.7),(24.6±1.9),P<0.001]和Lysholm评分[(55.8±9.8),(72.3±7.3),(77.9±6.2),(85.3±3.9),P<0.001]均显著增加。影像方面,与术前相比,术后3个月椎管面积显著增加[(151.9±37.2)mm2,(180.3±34.9)mm2,P=0.002]。[结论]腰膝综合征行腰椎减压手术治疗后,患者下肢放射痛、膝关节周围疼痛明显减轻,腰椎及膝关节功能、椎管面积显著改善。[Objective]To investigate the clinical outcomes of lumbar decompression in the treatment of lumbo-knee syndrome.[Meth⁃ods]A retrospective study was done on 35 patients who received lumbar decompression for lumbo-knee syndrome from October 2021 to Jan⁃uary 2023.The clinical and imaging documents were evaluated.[Results]All patients had lumbar decompression performed successfully,with no cerebrospinal fluid leakage,allergic reaction,gastrointestinal discomfort and other complications.All of them were followed up for an average of(5.2±1.6)months.With time went from the point preoperatively to those 1 week,1 month and 3 months postoperatively,the VAS score for lower limb radiation pain[(6.2±1.0),(2.4±0.7),(1.1±0.7),(0.5±0.7),P<0.001],the VAS score for pain around the knee[(5.1±1.1),(2.1±1.1),(1.2±0.7),(0.9±0.9),P<0.001],WOMAC score[(51.1±9.5),(31.5±6.6),(16.9±.0),(10.3±3.7),P<0.001]significantly decreased,while the JOA score[(9.2±2.1),(21.3±1.8),(23.5±1.7),(24.6±1.9),P<0.001]and Lysholm score[(55.8±9.8),(72.3±7.3),(77.9±6.2),(85.3±3.9),P<0.001]significantly increased.In terms of imaging,the spinal canal area was significantly increased at 3 months after surgery com⁃pared with that before surgery[(151.9±37.2)mm2,(180.3±34.9)mm2,P=0.002].[Conclusion]After lumbar decompression for lumbo-knee syndrome,the radiative pain of lower limbs and pain around the knee are significantly reduced,while the function of the lumbar spine and knee,as well as spinal canal area are significantly improved.

关 键 词：腰膝综合征 经皮椎间孔镜技术 单侧双通道内镜技术 腰椎后路椎间融合术 

分 类 号：R687[医药卫生—骨科学]