经皮内镜下腰椎后路椎间融合术治疗退行性腰椎管狭窄症的临床分析  

Clinical Analysis of Percutaneous Endoscopic Posterior Lumbar Intervertebral Fusion for the Treatment of Degenerative Lumbar Spinal Stenosis

作　　者：唐骞 陈啟鸰 贾祎佳 姬林松 杨再松 罗春山 陆廷盛 TANG Qian;CHEN Qi-ling;JIA Yi-jia;JI Lin-song;YANG Zai-song;LUO Chun-shan;LU Ting-sheng(Department of Orthopedics,Beijing Jishuitan Hospital Guizhou Hospital,Guiyang 550000,Guizhou Province,China)

机构地区：[1]北京积水潭医院贵州医院骨科,贵州贵阳550000

出　　处：《罕少疾病杂志》2024年第9期105-107,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 分析经皮内镜下腰椎后路椎间融合术(PE-PLIF)治疗退行性腰椎管狭窄症(DLSS)的临床疗效。方法 将本院2021年1月-2022年12月退行性DLSS患者(100例)设为研究对象,按随机数字表法分组(对照组、研究组),50例/组。对照组行后路椎体融合术治疗、研究组行PE-PLIF治疗,对比两组手术指标(手术时间、术后卧床时间、住院时间及术中出血量)、术后疼痛评分、手术前后脊髓功能评分(JOA)、手术前后Oswestry功能障碍指数评分(ODI)及术后并发症发生情况。结果 研究组的手术时间、术后卧床时间、住院时间均短于对照组,术中出血量低于对照组(P<0.05);研究组术后当日、术后第一周、术后第二周、术后第四周疼痛评分与对照组相比较低(P<0.05);术前两组JOA、ODI评分对比差异无统计学意义(P>0.05),术后两组JOA评分高于术前,ODI评分低于术前,差异有统计学意义(P<0.05);术后两组JOA、ODI评分对比差异无统计学意义(P>0.05);研究组术后并发症发生率低于对照组(P<0.05),分别为2.00%、18.00%。结论 对比后路椎体融合术,DLSS行PE-PLIF可取得更理想的治疗效果,手术操作期间所花费时间更短,能减少术中出血量,降低疼痛程度,术式应用有着较高的安全性,利于患者术后康复。Objective To analyze the clinical efficacy of percutaneous endoscopic lumbar posterior intervertebral body fusion(PE-PLIF)in the treatment of degenerative lumbar spinal stenosis(DLSS).Methods Degenerative DLSS patients(100 cases)from January 2021 to December 2022 were set as study subjects,and they were divided by random number table group(control group,study group),50 cases/group.The control group underwent posterior vertebral fusion treatment,and the study group received PE-PLIF treatment.The surgical indicators(operation time,postoperative bed time,hospital stay and intraoperative blood loss),postoperative pain score,spinal cord function score before and after surgery(Japanese Orthopaedic Association Scores,JOA),Oswestry dysfunction index score(ODI)before and after surgery and the occurrence of postoperative complications were compared.Results The operation time,postoperative bed time and hospital stay in the study group were shorter than the control group,the intraoperative blood loss was lower than that of the control group(P<0.05);The pain scores of the study group on the postoperative day,the first week,the second week,and the fourth week were low compared with the control group(P<0.05);there was no significant difference in JOA and ODI scores between the two groups(P>0.05),JOA scores in both groups than before surgery,the ODI score was lower than the preoperative,the difference was statistically significant(P<0.05);there was no significant difference in JOA and ODI scores between the two groups(P>0.05);the incidence of postoperative complications in the study group was lower than that in the control group(P<0.05),Of 2.00%and 18.00%,respectively.Conclusion Compared with posterior vertebral fusion,DLSS with PE-PLIF can achieve more ideal therapeutic effect,and has the advantages of short operation time,less intraoperative bleeding,quick postoperative recovery,low postoperative pain and low incidence of postoperative complications.

关 键 词：经皮内镜下腰椎后路椎间融合术 腰椎管狭窄症 并发症 疼痛 

分 类 号：R687.3[医药卫生—骨科学]