单通道脊柱内镜与单边双通道脊柱内镜技术治疗腰椎管狭窄症临床疗效分析  

Clinical Analysis of Single-channel Spinal Endoscopy and Single-side Double-channel Spinal Endoscopy in the Treatment of Lumbar Spinal Stenosis

作　　者：李想[1] 贺海怿 李鹏[1] 马琳[1] 郭强[1] 张鹏飞[1] 张凯[1] 聂富祥[1] LI Xiang;HE Hai-yi;LI Peng;MA Lin;GUO Qiang;ZHANG Peng-fei;ZHANG Kai;NIE Fu-xiang(Spinal Surgery Department,Sanmenxia Central Hospital,Henan Province 472000,China)

机构地区：[1]河南省三门峡市中心医院脊柱外科,472000

出　　处：《颈腰痛杂志》2024年第5期834-839,844,共7页The Journal of Cervicodynia and Lumbodynia

基　　金：三门峡市科技发展项目(编号:2021004035)。

摘　　要：目的探讨单通道脊柱内镜与单边双通道脊柱内镜技术在腰椎管狭窄症的手术减压情况、术后疗效和手术安全性。方法收集该科自2020年7月~2022年7月开展脊柱内镜手术治疗的79例LSS患者资料(包括单通道脊柱内镜手术33例,纳入单通道组;单边双通道脊柱内镜手术46例,纳入双通道组)。对两组患者的围手术期指标和疗效指标、减压节段椎间隙硬膜囊横截面积进行分组比较。结果两组患者的手术时间、住院时间和手术并发症情况比较,差异均不显著(P>0.05)。与术前相比较,两组患者术后1个月的腰痛、下肢痛VAS和ODI评分均明显改善(P<0.05),术后12个月这3项指标均进一步改善(P<0.05);上述3项指标的两组间比较,差异均不显著(P>0.05)。术后12个月时,单通道组的优良率90.1%(30/33),双通道组为91.3%(42/46),两组差异不显著(P>0.05)。与术前相比,两组患者术后1个月的硬膜囊横截面积均明显增加(P<0.05),且双通道组的硬膜囊横截面积和术后增加值均显著大于单通道组(P<0.05)。结论单通道与单边双通道脊柱内镜减压术治疗腰椎管狭窄症均可获得满意的减压效果,单通道脊柱内镜手术仅需单一切口,创伤相对更少;而单边双通道脊柱内镜手术则操作更为灵活,减压更为彻底。Objective To investigate the surgical decompression,postoperative effectiveness and surgical safety of single-channel spinal endoscopy and single-side double-channel spinal endoscopy in the treatment of lumbar spinal stenosis.Methods A total of 79 patients with LSS who underwent spinal endoscopic surgery in our department from July 2020 to July 2022 were collected.Among them,33 cases were treated with single-channel spinal endoscopy and included in the single-channel group,and 46 cases were treated with single-side double-channel spinal endoscopy and included in the double-channel group.Compared the perioperative and therapeutic indicators,as well as the cross-sectional area of the dural sac in the decompression segment,between two groups of patients.Results There were no significant differences in operation time,hospital stay,and surgical complications between the two patient groups(P>0.05).Compared with preoperative status,both groups showed significant improvements in Visual Analog Scale(VAS)scores for low back pain and lower extremity pain,as well as Oswestry Disability Index(ODI)scores one month after surgery(P<0.05).These three indicators further improved at 12 months postoperatively(P<0.05);however,the comparisons of these indicators between the two groups were not significant(P>0.05).At 12 months postoperatively,the excellent and good rate was 90.1%(30/33)in the single-channel group and 91.3%(42/46)in the dual-channel group,with no significant difference between the two groups(P>0.05).Compared with preoperative status,the cross-sectional area of the dural sac significantly increased in both groups one month after surgery(P<0.05),and both the cross-sectional area of the dural sac and its postoperative increase were significantly greater in the dual-channel group than in the single-channel group(P<0.05).Conclusion Both single-channel and unilateral dual-channel spinal endoscopic decompression surgeries can achieve satisfactory decompression effects for the treatment of lumbar spinal stenosis.The single-chan

关 键 词：腰椎管狭窄症 脊柱微创手术 单通道内镜 单边双通道内镜 

分 类 号：R687.3[医药卫生—骨科学]