三种椎间孔镜技术治疗单节段单侧症状腰椎管狭窄症的临床疗效  

Clinical efficacy of three foraminal endoscopic techniques in the treatment of single -level unilateral symptomatic lumbar spinal stenosis

作　　者：关月红 吴健[2] 汪李军[2] 徐斌[2] 沈玄霖[1] GUAN Yuehong;WU Jian;WANG Lijun;XU Bin;SHEN Xuanlin(Department of Rehabilitation,Second People's Hospital of Changshu,Changshu 215500,CHINA)

机构地区：[1]常熟市第二人民医院康复科,江苏215500 [2]常熟市第二人民医院脊柱骨科,江苏215500

出　　处：《江苏医药》2025年第3期281-285,共5页Jiangsu Medical Journal

摘　　要：目的 观察三种椎间孔镜技术治疗单节段单侧症状腰椎管狭窄症的临床疗效。方法 行椎间孔入路椎管减压术的108例单节段单侧症状腰椎管狭窄症患者分为三维(3D)打印辅助I See椎间孔镜(A)组、I See椎间孔镜(B)组和常规椎间孔镜(C)组,每组36例。记录三组通道建立时间、手术时间及摄片次数。测量三组手术前后侧隐窝直径和椎管面积。评估三组术前和术后3d、6个月、12个月VAS疼痛评分和日本骨科学会(JOA)评分。比较三组临床有效率和术后并发症发生率。结果 与C组比较,A组和B组通道建立时间延长,但手术时间缩短,摄片次数减少(P<0.05),且A组手术时间短于B组(P<0.05)。与术前比较,三组术后侧隐窝直径和椎管面积均增加,术后3d和6、12个月VAS疼痛评分均降低,而JOA评分均升高(P<0.05)。与C组比较,A组和B组术后侧隐窝直径和椎管面积增加,术后6、12个月VAS疼痛评分降低,而JOA评分升高(P<0.05)。与B组比较,A组术后椎管面积增大,术后6、12个月VAS疼痛评分降低,而术后6个月JOA评分升高(P<0.05)。三组临床有效率和术后并发症发生率均相仿(P>0.05)。结论 三种椎间孔镜技术治疗单节段单侧症状腰椎管狭窄症的临床疗效确切。其中,I See椎间孔镜技术在手术时间、摄片次数、疼痛程度减轻和腰椎神经功能改善等方面更有优势,而3D打印辅助I See椎间孔镜技术可以放大I See椎间孔镜技术优势。Objective To observe the clinical efficacy of three foraminal endoscopic techniques in the treatment of single-level unilateral symptomatic lumbar spinal stenosis.Methods A total of 108 patients with single-level unilateral symptomatic lumbar spinal stenosis were divided into three groups with 36 cases each.The lateral foraminoscopy decompression was performed with different foraminal endoscopic techniques of 3D printing assisted I See foraminoscopy(group A),I See foraminoscopy(group B) and conventional foraminoscopy(group C).The time for channel establishment,operation time and number of radiography were recorded.The lateral recess diameter and vertebral canal area were measured before and after operation.VAS pain scores and Japanese Orthopaedic Society(JOA) scores were evaluated at the time points of before operation(T0),3 days after operation(T1),6 months(T2) and 12 months(T3) after operation.The clinical effective rate and incidence of postoperative complications were compared among the three groups.Results Compared with group C,the time of channel establishment was prolonged,but operation time was shortened,and the number of radiography was less in groups of A and B(P<0.05).The operation time in group A was shorter than that in group B(P<0.05).Compared to T0,the lateral recess diameter and vertebral canal area of three groups were increased after operation,VAS pain scores were decreased and JOA scores were increased at T1,T2 and T3(P<0.05).Compared with group C,the lateral recess diameter and vertebral canal area after operation were increased,VAS pain scores were decreased and JOA scores were increased at T2 and T3 in the groups of A and B(P<0.05).Compared with group B,the vertebral canal area after operation was increased,VAS pain scores at T2 and T3 were decreased,while JOA score at T3 was increased in group A(P<0.05).The clinical effective rate and incidence of postoperative complications of the three groups were similar(P>0.05).Conclusion The three foraminal endoscopic techniques in the treatment of sin

关 键 词：腰椎管狭窄症 I See椎间孔镜 三维打印辅助 

分 类 号：R681[医药卫生—骨科学]