经皮椎板间入路治疗单节段腰椎间盘突出症伴椎管狭窄的临床疗效分析  

Clinical effect analysis of percutaneous interlaminar approach in the treatment of single segment lumbar disc herniation with spinal stenosis

作　　者：张卫帅 路绪超 韩中伟 朱贤友 ZHANG Weishuai;LU Xuchao;HAN Zhongwei;ZHU Xianyou(Department of Spinal Surgery,Kaifeng People′s Hospital,Kaifeng 475000)

机构地区：[1]开封市人民医院脊柱外科,开封475000

出　　处：《颈腰痛杂志》2025年第1期158-161,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：河南省开封市科技计划发展项目(2203088);河南省开封市科技研发计划联合基金项目(2307001);河南省开封市骨科微创治疗重点实验室(汴科文202067)。

摘　　要：目的观察经皮椎板间入路椎间盘摘除术治疗单节段腰椎间盘突出症伴椎管狭窄的疗效。方法回顾性分析2019年5月至2021年7月因腰椎间盘突出在开封市人民医院住院并行椎板间入路经皮内镜手术治疗的患者27例,所有患者影像学检查均可见相应水平椎管狭窄,对比患者术前、术后1 d、术后1年腰腿痛视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI),末次随访根据改良MacNab疗效评价标准评价治疗效果。结果所有患者均完成随访1年,末次随访总优良率达到92.59%,所有患者术前、术后1 d、术后1年腰腿痛VAS评分分别为:7.70±0.78、2.30±0.91、0.66±0.78;术前、术后1 d、术后1年ODI指数分别为:(75.07±11.59)%、(36.74±4.16)%、(11.56±2.74)%;各时间点VAS评分及ODI指数两两比较均有明显好转(P<0.05),末次随访改良MacNab疗效评价:优20例(74.07%),良5例(18.52%),可2例(7.41%),总优良率92.59%。结论经皮内镜椎板间入路技术治疗单节段腰椎间盘突出症伴椎管狭窄具有良好的临床效果。Objective To observe the efficacy of percutaneous interlaminar discectomy PEID in the treatment of single-segment lumbar disc herniation with spinal stenosis.Methods A retrospective analysis was performed on 27 patients admitted to Kaifeng People′s Hospital from May 2019 to July 2021 for lumbar disc herniation who received percutaneous endoscopic surgery through interlaminar approach.Imaging examination showed that all patients had spinal stenosis at corresponding level.Visual analogue scale(VAS)and Oswestry dysfunction index(ODI)were compared in patients with low back and leg pain before surgery,1 day and 1 year after surgery.At the last follow up,the therapeutic effect was evaluated according to the modified MacNab efficacy evaluation criteria.Results All patients were followed up for 1 year,and the overall good and good rate of the last follow up was 92.59%.The VAS scores of all patients before surgery,1 day after surgery,and 1 year after surgery were 7.70±0.78,2.30±0.91,0.66±0.78,respectively.The ODI index before surgery,1 day after surgery and 1 year after surgery were(75.07±11.59)%,(36.74±4.16)%,(11.56±2.74)%,respectively.The pairwise comparison of VAS scale and ODI index at each time point was significantly improved(P<0.05).The efficacy evaluation of modified MacNab at the last follow-up:20 cases(74.07%)were excellent,5 cases(18.52%)were good and 2 cases(7.41%)were fair,and the overall excellent and good rate was 92.59%.Conclusion Percutaneous endoscopic interlaminar approach has good clinical effect in the treatment of single level lumbar disc herniation with spinal stenosis.

关 键 词：脊柱内镜 单节段 椎板间入路 腰椎间盘突出症 腰椎管狭窄 疼痛评分 功能障碍指数 

分 类 号：R687.3[医药卫生—骨科学]