单侧双通道脊柱内镜与椎板开窗椎间盘切除术治疗腰椎间盘突出症合并腰椎管狭窄症的疗效对比  

Comparison of curative effects between unilateral biportal endoscopy and laminotomy discectomy for the treatment of lumbar disc herniation combined with lumbar spinal stenosis

作　　者：吕强 刘睿 柳申鹏[1] LYU Qiang;LIU Rui;LIU Shenpeng(Department of Spinal Surgery,Orthopedic Hospital,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100)

机构地区：[1]新乡医学院第一附属医院骨科医院脊柱外科专业组,新乡453100

出　　处：《颈腰痛杂志》2025年第1期64-68,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：河南省高等学校重点科研项目计划(19A320003)。

摘　　要：目的对比分析单侧双通道脊柱内镜与椎板开窗椎间盘切除术治疗腰椎间盘突出症合并腰椎管狭窄症的疗效。方法纳入2021年2月至2023年2月新乡医学院第一附属医院骨外科收治的92例腰椎间盘突出症合并腰椎管狭窄症患者,依照随机数表法分为研究组和对照组,对照组采用椎板开窗椎间盘切除术治疗,研究组采用单侧双通道脊柱内镜手术治疗。比较两组患者手术指标、疼痛评分(VAS)、Oswestry功能障碍指数(ODI)、MacNab优良率及手术相关并发症发生情况。结果研究组下床活动时间、住院时间均短于对照组(P<0.05);术后3个月,两组VAS评分均降低,且研究组低于对照组(P<0.05);术后3个月,两组ODI指数均降低,且研究组低于对照组(P<0.05);研究组MacNab优良率高于对照组(P<0.05)。结论单侧双通道脊柱内镜治疗腰椎间盘突出症合并腰椎管狭窄患者可以缩短手术时间,加快术后康复,并且可以减轻疼痛,改善腰椎功能,疗效确切,安全可靠。Objective To compare and analyze the efficacy of unilateral biportal endoscopy and laminectomy in the treatment of lumbar disc herniation with lumbar spinal stenosis.Methods A total of 92 patients with lumbar disc herniation combined with lumbar spinal stenosis admitted to the department of orthopedics,the First Affiliated Hospital of Xinxiang Medical College from February 2021 to February 2023 were selected and randomly divided into study group and control group.The control group was treated with laminectomy and discectomy,while the study group was treated with unilateral biportal endoscopy surgery.The surgical parameters,visual analogue pain score(VAS),Oswestry dysfunction index(ODI),excellent and good rate of MacNab,surgical related complications were compared.Results The get out of bed activity time and hospitalization time of the study group were shorter than those of control group(P<0.05).Three months after surgery,VAS scores in both groups decreased,and study group was lower than that of control group(P<0.05).Three months after surgery,the ODI index in both groups decreased,and the study group was lower than control group(P<0.05).Excellent and good rate of MacNab in study group was higher than that in control group(P<0.05).Conclusion Unilateral biportal endoscopy for the treatment of patients with lumbar disc herniation and lumbar spinal stenosis can shorten the operation time,accelerate postoperative recovery,reduce pain,improve lumbar function and have a definite therapeutic effect,and it is safe and reliable.

关 键 词：单侧双通道脊柱内镜 椎板开窗椎间盘切除术 腰椎间盘突出 腰椎管狭窄 外科手术 OSWESTRY功能障碍指数 

分 类 号：R687.3[医药卫生—骨科学]