| 单侧双通道内镜下经对侧入路治疗腰椎间孔狭窄症的临床疗效 |
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投稿时间：2023-05-23
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| 作者 | Author | 单位 | Address | E-Mail |
| 程伟 |
CHENG Wei |
浙江中医药大学附属杭州市中医院, 浙江 杭州 310007 |
Hangzhou TCM Hospital of Zhejiang Traditional Chinese Medical University, Hangzhou 310007, Zhejiang, China |
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| 邵荣学 |
SHAO Rong-xue |
浙江中医药大学附属杭州市中医院, 浙江 杭州 310007 |
Hangzhou TCM Hospital of Zhejiang Traditional Chinese Medical University, Hangzhou 310007, Zhejiang, China |
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| 朱承跃 |
ZHU Cheng-yue |
浙江中医药大学附属杭州市中医院, 浙江 杭州 310007 |
Hangzhou TCM Hospital of Zhejiang Traditional Chinese Medical University, Hangzhou 310007, Zhejiang, China |
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| 王栋 |
WANG Dong |
浙江中医药大学附属杭州市中医院, 浙江 杭州 310007 |
Hangzhou TCM Hospital of Zhejiang Traditional Chinese Medical University, Hangzhou 310007, Zhejiang, China |
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| 张伟 |
ZHANG Wei |
浙江中医药大学附属杭州市中医院, 浙江 杭州 310007 |
Hangzhou TCM Hospital of Zhejiang Traditional Chinese Medical University, Hangzhou 310007, Zhejiang, China |
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| 潘浩 |
PAN Hao |
浙江中医药大学附属杭州市中医院, 浙江 杭州 310007 |
Hangzhou TCM Hospital of Zhejiang Traditional Chinese Medical University, Hangzhou 310007, Zhejiang, China |
harper1966@alu.zcmu.edu.cn |
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| 期刊信息：《中国骨伤》2024年，第37卷，第4期，第331-337页 |
| DOI：10.12200/j.issn.1003-0034.20221040 |
| 基金项目:浙江省医药卫生科技计划项目(编号:2022KY997,2022KY999) |
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中文摘要:
目的: 评估单侧双通道内镜技术经对侧入路治疗腰椎椎间孔狭窄症的可行性及影像学结果。
方法: 回顾性分析2021年1月至2022年7月收治的33例接受单侧双通道内镜技术治疗腰椎间孔狭窄症患者的临床资料,男17例,女16例;年龄34~72(56.00±7.89)岁;记录手术时间、围手术期并发症;采用疼痛视觉模拟评分法(visual analogue scale,VAS)评估患者腰痛和下肢疼痛程度,Oswestry功能障碍指数(Oswestry disability index,ODI)评估腰椎功能状况;末次随访时采用改良Macnab评分标准评价临床疗效。
结果: 所有患者顺利完成手术,手术时间47~65(56.10±5.19) min;术后随访12~18(14.9±2.3)个月。术前腰腿痛VAS[(7.273±1.442)分,(7.697±1.447)分],ODI(69.182±9.740) %;术后腰腿痛VAS[(3.394±0.966分,(2.818±0.727)分],ODI (17.30±4.78) %;末次随访腰腿痛VAS[(2.788±0.650)分,(2.394±0.704)分],ODI (14.33±3.50) %。术后腰腿痛VAS及ODI与术前比较,差异均有统计学意义(P<0.05)。1例术后出现脑脊液漏,经治疗后状况良好。末次随访时,根据改良Macnab评定标准,优24例,良5例,可2例,差2例。
结论: 单侧双通道内镜下经对侧入路治疗腰椎间孔狭窄症,操作安全、高效,并发症少,术后恢复快,临床疗效满意,在随访期间,患者未出现医源性腰椎不稳定。 |
| 【关键词】腰椎间孔狭窄症 单侧双通道内镜技术 经皮内镜腰椎间盘切除术 |
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| Contralateral endoscopic approach for lumbar foraminal stenosis using unilateral biportal endoscopic surgery |
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ABSTRACT
Objective To assess the feasibility and imaging outcomes of unilateral biportal endoscopic technique in the treatment of lumbar foraminal stenosis through contralateral approach.
Methods The clinical data of 33 patients with lumbar foraminal stenosis treated with unilateral biportal endoscopic technique from January 2021 to July 2022 were retrospectively analyzed. There were 17 males and 16 females;age ranging from 34 to 72 years old with an average of (56.00±7.89) years old;operation time and perioperative complications were recorded;visual analogue scale (VAS) of pain was recorded,to evaluate the degree of low back pain and lower extremity pain,and Oswestry disability index (ODI) to evaluate the lumbar spine function. At the latest follow-up,the modified Macnab score was used to evaluate the clinical efficacy.
Results All patients successfully completed the operation. The operation time ranged from 47 to 65 minutes,with an average of (56.10±5.19) minutes. The postoperative follow-up ranged from 12 to 18 months,with an average of (14.9±2.3) months. The VAS of low back and lower extermity pain before operation were (7.273±1.442) and (7.697±1.447) scores,ODI was (69.182±9.740) %. Postoperative lumbocrural pain VAS were (3.394±0.966) and (2.818±0.727) scores,ODI was (17.30±4.78) %. At the latest follow-up,VAS of back and lower extermity pain was (2.788±0.650) and (2.394±0.704) scores,ODI was (14.33±350) %. There were significant differences in VAS of low back and lower extremity pain and ODI before and after operation(P<0.05). At the latest follow-up,according to the modified Macnab criteria,24 patients got excellent result,5 as good,2 as fair,and 2 as poor.
Conclusion Unilateral biportal endoscopic treatment of lumbar foraminal stenosis through the contralateral approach is a safe and efficient method,with few complications,quick postoperative recovery,and satisfactory clinical outcomes. During the follow-up period,no iatrogenic lumbar instability was observed. |
| KEY WORDS Lumbar foraminal stenosis Unilateral biportal endoscopic Percutaneous endoscopic discectomy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 程伟,邵荣学,朱承跃,王栋,张伟,潘浩.单侧双通道内镜下经对侧入路治疗腰椎间孔狭窄症的临床疗效[J].中国骨伤,2024,37(4):331~337 |
| 英文格式: | CHENG Wei,SHAO Rong-xue,ZHU Cheng-yue,WANG Dong,ZHANG Wei,PAN Hao.Contralateral endoscopic approach for lumbar foraminal stenosis using unilateral biportal endoscopic surgery[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(4):331~337 |
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