| 经皮椎间孔镜下椎间孔成形术治疗单纯腰椎管侧方出行区狭窄 |
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投稿时间：2020-01-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 罗科锋 |
LUO Ke-feng |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 蒋国强 |
JIANG Guo-qiang |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
jiangguoqiang@nbu.edu.com |
| 卢斌 |
LU Bin |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 蔡凯文 |
CAI Kai-wen |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 岳兵 |
YUE Bing |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 陆继业 |
and LU Ji-ye |
宁波大学医学院附属医院骨科, 浙江 宁波 315020 |
Department of Orthopaedics, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
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| 期刊信息：《中国骨伤》2020年，第33卷，第5期，第420-425页 |
| DOI：10.12200/j.issn.1003-0034.2020.05.006 |
| 基金项目: |
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中文摘要:
目的：探讨经皮椎间孔镜下行椎间孔成形术治疗单纯腰椎管侧方出行区狭窄的治疗效果。
方法：2013年1月至2018年6月收治单纯腰椎管侧方出行区狭窄症患者36例，入院行选择性神经根管造影及阻滞术，根据症状及患方意愿，22例行Ⅰ期经皮椎间孔镜下椎间孔成形术治疗（Ⅰ期手术组），另14例出院后因症状复现而再次入院手术治疗，设为延迟手术组。记录治疗前、阻滞后1 d、再入院前（延迟手术组）、手术后1 d、3个月、6个月的患侧下肢疼痛视觉模拟评分（visual analogue scale，VAS）及Oswestry功能障碍指数（Oswestry Disability Index，ODI），评价治疗效果。
结果：36例患者术后各个时期的VAS和ODI与治疗前比较明显改善（P<0.05），且维持良好并呈持续下降趋势；VAS术后6个月较术后1 d改善明显（P<0.05）；ODI术后1 d与术后3个月、术后1 d与术后6个月、术后3个月与6个月差异均有统计学意义（P<0.05）。延迟手术组阻滞后1 d的VAS和ODI优于Ⅰ期手术组。延迟手术组再入院前VAS和ODI较自身阻滞后有显著升高。两组术后各个时期的VAS评分和ODI指数组间比较差异均无统计学意义（P>0.05），但与自身治疗前和（或）再入院前相比差异均有统计学意义（P<0.01）。所有病例未出现神经损伤，仅2例出口根刺激症状者于短期保守治疗后缓解。
结论：单纯腰椎管侧方出行区狭窄使用选择性神经根管阻滞治疗效果持续性可能欠佳，经皮椎间孔镜治疗是一种简单、安全、有效的方法。 |
| 【关键词】腰椎管侧方出行区狭窄 经皮椎间孔镜术 椎间孔成形术 |
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| Percutaneous transforaminal endoscopic foraminoplasty for simple lumbar spinal lateral exit-zone stenosis |
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ABSTRACT
Objective: To evaluate the clinical effects of percutaneous endoscopic foraminoplasty for simple lumbar spinal lateral exit-zone stenosis.
Methods: A total of 36 patients with simple lumbar spinal lateral exit-zone stenosis were admitted to our hospital from January 2013 to June 2018,and received selective nerve root canal radiography and radicular block. According to the symptoms and patients' personal wills,22 cases underwent the one-stage percutaneous foraminal surgery(the one-stage operation group),and the other 14 patients were re-admitted to the hospital for operation(the delayed operation group) because of the recurrence of symptoms after discharge. The visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical effects before therapy,1 day after the radicular block,and 1 day,3 months and 6 months after the operation.
Results: VAS and ODI of all 36 cases were obviously improved(P<0.05) at various stages after the surgery and maintained well and showed a continuous downward trend. The VAS at 6 months after the operation was improved significantly compared with that at 1 day after the operation (P<0.05). When comparing the postoperative ODI between 1 day and 3 months after the surgery,1 day and 6 months after the surgery,3 months and 6 months after the surgery,the differences were statistically significant(P<0.05). The VAS and ODI of the one-stage operation group at 1 day after radicular block were better than those of delayed operation group. The VAS and ODI of delayed operation group before readmission were significantly higher than those at 1 day after radicular block. There were no significant differences in VAS and ODI at each stage after operation between two groups(P>0.05),but when compared with its own pretherapy andbefore readmission results,the difference was significant (P<0.05). There was no nerve injury in all cases. Only 2 cases were presented with the outlet root stimulation symptoms,and the symptoms relieved after short-term conservative treatment.
Conclusion: The clinical effects of radicular block may be unsustainable for patients with simple lumbar spinal lateral exit-zone stenosis. Instead,percutaneous endoscopic foraminoplasty was simple,safe and effective. |
| KEY WORDS Lumbar spinal lateral exit-zone stenosis Percutaneous transforaminal endoscopic surgery Foraminoplasty |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 罗科锋,蒋国强,卢斌,蔡凯文,岳兵,陆继业.经皮椎间孔镜下椎间孔成形术治疗单纯腰椎管侧方出行区狭窄[J].中国骨伤,2020,33(5):420~425 |
| 英文格式: | LUO Ke-feng,JIANG Guo-qiang,LU Bin,CAI Kai-wen,YUE Bing,and LU Ji-ye.Percutaneous transforaminal endoscopic foraminoplasty for simple lumbar spinal lateral exit-zone stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(5):420~425 |
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