| 单通道内镜下单侧椎板切开术进行双侧减压术式在腰椎融合术后邻椎病患者中的早期应用研究 |
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投稿时间：2024-08-02
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| 作者 | Author | 单位 | Address | E-Mail |
| 李涛 |
LI Tao |
长沙市中医医院 长沙市第八医院, 湖南 长沙 410100 |
Changsha Hospital of Traditional Chinese Medicine, Changsha Eighth Hospital, Changsha 410100, Hunan, China |
252821386@qq.com |
| 张斌 |
ZHANG Bin |
长沙市中医医院 长沙市第八医院, 湖南 长沙 410100 |
Changsha Hospital of Traditional Chinese Medicine, Changsha Eighth Hospital, Changsha 410100, Hunan, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第12期，第1153-1157页 |
| DOI：10.12200/j.issn.1003-0034.20240245 |
| 基金项目: |
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中文摘要:
目的: 探讨单通道内镜(Delta)下单侧椎板切开术行双侧减压术(unilateral laminotomy for bilateral decompression,ULBD)治疗腰椎融合术后邻椎病(adjacent segment disease,ASD)的临床疗效。
方法: 回顾性分析2021年1月至2023年1月采用脊柱内镜ULBD治疗的腰椎融合术后ASD 24例,男10例,女14例; 年龄54~77(59.2±3.6)岁; L2,3 2例,L3,4 16例,L5S1 6例。记录患者手术时间、术中出血量,分别于术前、术后1周及术后1、3、6个月记录下肢痛疼痛视觉模拟评分(visual analogue scale,VAS)及Oswestry功能障碍指数(Oswestry disability index,ODI),采用改良 MacNab 评分标准评价临床疗效。
结果: 24例患者均顺利完成手术,术中无神经损伤、硬膜损伤脑脊液漏,手术时间(90.3±11.8) min,术中出血量(35.3±5.3) ml,住院时间(14.4±2.1) d。24例患者均获得6个月的随访。ODI、VAS分别由术前的(51.25±5.48)%、(6.88±1.23)分改善至术后1周的(9.29±1.76)%、(1.13±0.95)分(P<0.05);术后1个月ODI、VAS(9.17±1.90)%、(1.67±0.82)分较术后1周改善(P<0.05)。术后1、3、6个月ODI及 VAS 比较,差异无统计学意义(P>0.05)。末次随访时,按照改良 MacNab 标准,优8例,良 13例,可3例。
结论: 单通道内镜(Delta)下ULBD手术治疗腰椎融合术后ASD患者,具有创伤小、出血少、手术时间短、术后恢复快等优势,临床疗效满意。 |
| 【关键词】腰椎融合术 邻椎病 脊柱内镜 腰椎管狭窄症 |
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| Early application of bilateral decompression under single channel endoscopic laminectomy in patients with adjacent vertebrae after lumbar fusion |
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ABSTRACT
Objective To explore clinical effect of unilateral laminotomy for bilateral decompression (ULBD) under single channel endoscopic(Delta) in treating adjacent segment disease(ASD) after lumbar fusion.
Methods A retrospective analysis of 24 patients who underwent spinal endoscopic ULBD after lumbar fusion was performed from January 2021 to January 2023,including 10 males and 14 females,aged from 54 to 77 years old with an average of (59.2±3.6) years old;2 patients with L2,3,16 patients with L3,4,and 6 patients with L5S1. Operative time and intraoperative blood loss were recorded,visual analogue scale (VAS) and Oswestry disability index (ODI) were recorded before oepration,1 week,1,3 and 6 months after operation,respectively;the modified MacNab standard score evaluation was used to evaluate clinical effects.
Results All patients were successfully completed operation without nerve injury or dural injury and cerebrospinal fluid leakage. Operation time was (90.3±11.8) min,intraoperative blood loss was (35.3±5.3) ml,and hospital stay was (14.4±2.1) d. All 24 patients were followed up for 6 months. ODI and VAS were improved from (51.25±5.48)% and (6.88±1.23) before operation to (9.29±1.76)% and (1.13±0.95) at one week after operation,respectively (P<0.05). ODI,VAS (9.17±1.90)% and(1.67±0.82),were improved at 1 month compared with 1 week after operation (P<0.05). There were no significant difference in postoperative ODI and VAS at 1,3 and 6 months (P>0.05). At the latest follow-up,8 patients got excellent result,13 good,and 3 fair according to the modified MacNab standard.
Conclusion ULBD under single channel endoscopy (Delta) has advantages of less trauma,less bleeding,short operation time,rapid postoperative recovery,and could receive satisfactory clinical effect. |
| KEY WORDS Lumbar fusion Adjacent segment disease Spinal endoscopy Lumbar spinal stenosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李涛,张斌.单通道内镜下单侧椎板切开术进行双侧减压术式在腰椎融合术后邻椎病患者中的早期应用研究[J].中国骨伤,2024,37(12):1153~1157 |
| 英文格式: | LI Tao,ZHANG Bin.Early application of bilateral decompression under single channel endoscopic laminectomy in patients with adjacent vertebrae after lumbar fusion[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(12):1153~1157 |
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