单侧双通道内镜下减压与全椎板切除减压融合内固定治疗重度腰椎管狭窄症的效果比较  

Comparison of effects of unilateral biportal endoscopic decompression and total laminectomy with fusion and internal fixation in the treatment of severe lumbar spinal stenosis

作　　者：周昆鹏 王鑫鑫 张本立[1] Zhou Kunpeng;Wang Xinxin;Zhang Benli(Department of Orthopedics,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院骨科,周口466000

出　　处：《中国实用医刊》2024年第1期37-40,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较单侧双通道内镜下减压与全椎板切除减压融合内固定治疗重度腰椎管狭窄症(LSS)的效果。方法随机对照研究。抽取2020年1月至2022年12月周口市中心医院收治的重度LSS患者74例,按随机数字表法分为对照组和研究组,每组37例。对照组行全椎板切除减压融合内固定,研究组采用单侧双通道内镜下减压。比较两组围术期指标、腰部和腿部视觉模拟评分法(VAS)评分、腰椎Oswestry功能障碍指数(ODI)及并发症发生率。结果研究组术中出血量少于对照组,手术时长、术后首次下地时间、住院时间短于对照组(P<0.05)。术后7 d、6个月,研究组腰部和腿部VAS评分、ODI低于对照组(P<0.05)。研究组并发症发生率(2.70%,1/37)低于对照组(21.62%,8/37),差异有统计学意义(P<0.05)。结论与全椎板切除减压融合内固定相比,单侧双通道内镜下减压治疗重度LSS的效果更好,可缩短手术和住院时间,减轻机体创伤,缓解腰部和腿部疼痛症状,改善患者腰椎功能,且治疗安全性较高。Objective To compare the effects of unilateral biportal endoscopic decompression and total laminectomy with fusion and internal fixation in the treatment of severe lumbar spinal stenosis(LSS).Methods This study was a randomized controlled trail.A total of 74 patients with severe LSS who were treated in Zhoukou Central Hospital from January 2020 to December 2022 were selected,and they were divided into control group and study group by random number table method,with 37 cases in each group.The control group was treated by total laminectomy with fusion and internal fixation,and the study group was treated by unilateral biportal endoscopic decompression.The perioperative indicators,visual analogue scale(VAS)scores of waist and leg,Oswestry dysfunction index(ODI)and incidence of complications were compared between the two groups.Results Compared with the control group,the study group had less intraoperative blood loss,shorter operation time,shorter postoperative first ambulation time and shorter hospital stay(P<0.05).Compared with the control group,the study group had lower VAS scores of waist and leg and lower ODI 7 days and 6 months after operation(P<0.05).The incidence of complications in the study group(2.70%,1/37)was lower than that in the control group(21.62%,8/37),and the difference was significant(P<0.05).Conclusions Compared with total laminectomy with fusion and internal fixation,unilateral biportal endoscopic decompression is more effective in the treatment of severe LSS.It can shorten the operation time and hospital stay,reduce body trauma,relieve waist and leg pain,and improve lumbar function,with high safety.

关 键 词：椎管狭窄 腰椎 重度 单侧双通道内镜下减压 全椎板切除减压融合内固定 

分 类 号：R687.3[医药卫生—骨科学]