| 经皮椎间孔镜技术治疗老年腰椎侧隐窝狭窄症 |
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投稿时间：2022-12-19
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| 作者 | Author | 单位 | Address | E-Mail |
| 时福东 |
SHI Fu-dong |
中国中医科学院望京医院脊柱一科, 北京 100102 |
The First Department of Spinal Surgery, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine Sciences, Beijing 100102, China |
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| 张世民 |
ZHANG Shi-min |
中国中医科学院望京医院脊柱一科, 北京 100102 |
The First Department of Spinal Surgery, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine Sciences, Beijing 100102, China |
smzhang1117@163.com |
| 靳蛟 |
JIN Jiao |
中国中医科学院望京医院脊柱一科, 北京 100102 |
The First Department of Spinal Surgery, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine Sciences, Beijing 100102, China |
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| 吴冠男 |
WU Guan-nan |
中国中医科学院望京医院脊柱一科, 北京 100102 |
The First Department of Spinal Surgery, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine Sciences, Beijing 100102, China |
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| 马明 |
MA Ming |
中国中医科学院望京医院脊柱一科, 北京 100102 |
The First Department of Spinal Surgery, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine Sciences, Beijing 100102, China |
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| 刘昱彰 |
LIU Yu-zhang |
中国中医科学院望京医院脊柱一科, 北京 100102 |
The First Department of Spinal Surgery, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine Sciences, Beijing 100102, China |
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| 张兆杰 |
ZHANG Zhao-jie |
中国中医科学院望京医院脊柱一科, 北京 100102 |
The First Department of Spinal Surgery, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine Sciences, Beijing 100102, China |
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| 莫靖煊 |
MO Jing-xuan |
中国中医科学院望京医院脊柱一科, 北京 100102 |
The First Department of Spinal Surgery, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine Sciences, Beijing 100102, China |
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| 期刊信息：《中国骨伤》2023年，第36卷，第1期，第43-47页 |
| DOI：10.12200/j.issn.1003-0034.2023.01.008 |
| 基金项目:中国中医科学院科技创新工程重大攻关项目(编号:CI2021A02006) |
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中文摘要:
目的:探讨经皮椎间孔镜技术治疗老年腰椎侧隐窝狭窄的临床疗效及安全性。
方法:对2018年3月至2019年8月采取经皮椎间孔镜技术减压治疗的31例老年腰椎侧隐窝狭窄患者进行回顾性分析,其中男16例,女15例,年龄65~81(71.13±5.20)岁,病程3个月~7年,平均(14.36±6.52)个月。采用视觉模拟评分(visual analogue scale,VAS),Oswestry功能障碍指数(Oswestry disability index,ODI)评估术前及术后1,6,12个月临床症状及功能状态;末次随访采用改良Macnab标准评估临床疗效。
结果:手术均顺利完成,手术时间75~120(97.84±11.22) min。31例患者均获得随访,时间12~28(17.29±5.56)个月。术后1、6、12个月腰腿痛VAS及ODI较术前均得到明显改善(P＜0.01)。末次随访采用改良Macnab标准评定疗效,结果优23例,良5例,可3例。1例患者神经根与周围组织粘连严重,术后出现下肢感觉异常,给予中药加营养神经药物等保守治疗,术后2周恢复。无神经根损伤、感染等并发症出现。
结论:椎间孔镜技术在局麻下进行,操作时间短,在保证充分减压的同时又可减少并发症发生,是治疗老年腰椎侧隐窝狭窄症的一个安全、有效的的手术方法。 |
| 【关键词】腰椎侧隐窝狭窄 外科手术,内窥镜 椎间孔入路 老年人 |
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| Percutaneous foraminal endoscopy for the treatment of lumbar lateral recess stenosis in elderly |
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ABSTRACT
Objective To investigate the clinical efficacy and safety of percutaneous foraminal endoscopy in the treatment of lumbar lateral recess stenosis in elderly.
Methods The clinical data of 31 elderly patients with lumbar lateral recess stenosis treated by percutaneous foraminal endoscopic decompression from March 2018 to August 2019 were retrospectively analyzed. Including 16 males and 15 females,aged from 65 to 81 years with an average of (71.13±5.20) years,the course of disease ranged from 3 months to 7 years with an average of (14.36±6.52) months. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess clinical symptom and functional status before operation and 1,6,12 months after operation. At the final follow-up,the modified Macnab standard was used to evaluate clinical efficacy.
Results All patients were completed the operation successfully. The operation time was from 75 to 120 min with an average of (97.84±11.22) min. All 31 patients were followed up from 12 to 28 months with an average of (17.29±5.56) months. Postoperative lumbago-leg pain VAS and ODI were significantly improved at 1,6,and 12 months(P＜0.01). At the final follow-up,according to the modified Macnab standard to evaluate the effect,23 got excellent results,5 good,3 fair. One patient had severe adhesions between peripheral tissues and nerve root,and postoperative sensory abnormalities in the lower extremities were treated conservatively with traditional Chinese medicine and neurotrophic drugs,which recovered at 2 weeks after surgery. No complications such as nerve root injury and infection occurred.
Conclusion The intervertebral foraminal endoscopy technique,which is performed under local anesthesia for a short period of operation,ensures adequate decompression while minimizing complications,and is a safe and effective surgical procedure for elderly patients with lumbar lateral recess stenosis. |
| KEY WORDS Lumbar lateral recess stenosis Surgical procedures,endoscopic Intervertebral foramen approach Aged |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 时福东,张世民,靳蛟,吴冠男,马明,刘昱彰,张兆杰,莫靖煊.经皮椎间孔镜技术治疗老年腰椎侧隐窝狭窄症[J].中国骨伤,2023,36(1):43~47 |
| 英文格式: | SHI Fu-dong,ZHANG Shi-min,JIN Jiao,WU Guan-nan,MA Ming,LIU Yu-zhang,ZHANG Zhao-jie,MO Jing-xuan.Percutaneous foraminal endoscopy for the treatment of lumbar lateral recess stenosis in elderly[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(1):43~47 |
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