显微镜辅助下经椎板间隙与椎间孔入路手术治疗退行性腰椎管狭窄症的效果比较  

Comparison of therapeutic effect of microscope-assisted surgery via the interlaminar approach and the foraminal approach on degenerative lumbar spinal stenosis

作　　者：任毅 张海鸿[1] Ren Yi;Zhang Haihong(Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院,兰州730030

出　　处：《中国实用医刊》2024年第1期10-13,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较显微镜辅助下经椎板间隙与椎间孔入路手术治疗退行性腰椎管狭窄症的临床效果。方法随机对照研究。前瞻性抽取2022年2月至2023年1月于兰州大学第二医院就诊的96例退行性腰椎狭窄症患者为研究对象,按照随机数字表法分为椎板间隙组与椎间孔组,每组48例。两组患者均由同一组医护人员实施手术,椎板间隙组接受显微镜下经椎板间隙入路手术,椎间孔组接受显微镜下经椎间孔入路手术。观察并记录两组手术情况(包括手术时间、术中透视次数、术中出血量及住院时间);比较两组治疗前及术后6个月的腰椎功能[日本骨科协会(JOA)评分表评分]、疼痛情况[数字评定量表(NRS)评分];比较两组治疗效果及围术期并发症发生情况。结果椎间孔组手术时间、术中透视次数、术中出血量均多于椎板间隙组(P均<0.05),两组住院时间比较差异未见统计学意义(P>0.05)。术后6个月,两组JOA评分均高于治疗前,NRS评分均低于治疗前(P均<0.05),两组JOA、NRS评分比较差异未见统计学意义(P>0.05)。两组治疗效果以及优良率比较差异未见统计学意义(P>0.05)。两组均未见硬脊膜撕裂、永久性神经根损伤等并发症。结论显微镜辅助下经椎板间隙入路手术或经椎间孔入路手术治疗退行性腰椎管狭窄症均有良好的治疗效果及安全性,二者均能有效改善患者腰椎功能,缓解疼痛程度。相较于经椎间孔入路手术,经椎板间隙入路手术时间较短,术中透视次数及术中出血量较少,更具优势。Objective To compare the effect of microscope-assisted surgery via the interlaminar approach and the foraminal approach in the treatment of degenerative lumbar spinal stenosis.Methods This study was a randomized controlled trail.A total of 96 patients with degenerative lumbar spinal stenosis admitted to Lanzhou University Second Hospital from February 2022 to January 2023 were selected as research subjects prospectively.And they were divided into the laminar space group and the foramen group by random number table method,with 48 cases in each group.Both groups underwent surgery by the same medical team.The laminar space group was treated by microscope-assisted surgery via the interlaminar approach,and the foramen group was treated by microscope-assisted surgery via the foraminal approach.The operation conditions(including operation time,intraoperative fluoroscopy times,intraoperative blood loss,hospital stay)of the two groups were observed and recorded.The lumbar function evaluated by the Japanese Orthopaedic Association(JOA)score and pain degree evaluated by numerical rating scale(NRS)of the two groups were compared before and 6 months after operation.The therapeutic effects and the perioperative complications of the two groups were compared.Results Compared with the laminar space group,the foramen group exhibited a longer operation time,increased intraoperative fluoroscopy times,and higher intraoperative blood loss volume(all P<0.05);there was no significant difference in hospital stay between the two groups(P>0.05).Six months after surgery,the JOA score increased,and the NRS score decreased in both groups(all P<0.05),while there was no significant difference in scores of JOA and NRS between the two groups(P>0.05).There was no significant difference in overall treatment efficacy or excellent and good rate between the two groups(P>0.05).Neither group reported any complications such as dural laceration or permanent nerve root injury.Conclusions Microscope-assisted surgery via the interlaminar approach and the for

关 键 词：椎管狭窄 退行性 显微镜 椎板间隙入路 椎间孔入路 

分 类 号：R687.3[医药卫生—骨科学]