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改良经椎板间入路与传统入路治疗单节段腰椎椎管狭窄症的病例对照研究
Hits: 2424   Download times: 749   Received:November 14, 2019    
作者Author单位UnitE-Mail
董振宇 DONG Zhen-yu 新疆自治区中医院脊柱二科, 新疆 乌鲁木齐 830000 The Second Department of Orthopaedics, Affiliated Hospital of Xinjiang Autonomous Region, Urumqi 830000, Xinjiang, China  
周瑜博 ZHOU Yu-bo 新疆医科大学第四附属医院骨四科, 新疆 乌鲁木齐 830000  
黄异飞 HUANG Yi-fei 新疆自治区中医院脊柱二科, 新疆 乌鲁木齐 830000 The Second Department of Orthopaedics, Affiliated Hospital of Xinjiang Autonomous Region, Urumqi 830000, Xinjiang, China affen88jany@163.com 
期刊信息:《中国骨伤》2021年34卷,第4期,第337-340页
DOI:10.12200/j.issn.1003-0034.2021.04.008


目的: 探讨改良经椎板间入路治疗单节段腰椎椎管狭窄症的临床疗效。

方法: 选取2015年2月至2017年8月拟行内窥镜下手术治疗的单节段腰椎椎管狭窄症患者80例,其中男38例,女42例;年龄33~69(47.6±9.5)岁。采用随机数字表法分为研究组和传统组各40例,分别采用改良经椎板间入路和传统入路手术治疗。记录两组患者的手术时间、术中出血量、住院时间;比较手术前后不同时间的疼痛视觉模拟评分(visual analogue scale,VAS),Oswestry功能指数(Oswestry Disability Index,ODI);观察椎管面积、椎管内径、盘黄间隙及手术并发症。

结果: 80例患者均获得3个月以上的随访。2例出现切口感染,均为传统组患者;两组患者的手术时间差异无统计学意义(P>0.05);术中出血量和住院时间研究组均低于传统组(P<0.05);术后1周,术后3个月两组患者的VAS评分、ODI指数均较术前明显降低(P<0.05),但组间差异无统计学意义(P>0.05);术后3个月研究组患者的椎管面积、椎管内径测定值均大于传统组(P<0.05)。两组手术并发症发生率差异无统计学意义(P>0.05)。

结论: 改良经椎板间入路手术在单节段腰椎椎管狭窄症患者治疗中较传统入路具有创伤更小、恢复更快、术后椎管间隙恢复更好的优势。
[关键词]:椎管狭窄  内窥镜  手术入路  病例对照研究
 
Case-control study on the treatment of single-segment lumbar spinal stenosis with modified interlaminar approach and traditional approach
Abstract:

Objective: To explore the clinical effect of modified interlaminar approach for the treatment of single-segment lumbar spinal stenosis.

Methods: From February 2015 to August 2017,80 patients with single-segment lumbar spinal stenosis planned to undergo endoscopic surgery were selected,including 38 males and 42 females;aged 33 to 69(47.6±9.5) years old. Using random number table method,the patients were divided into study group and traditional group,40 cases in each group, and underwent surgical treatment through modified translaminar approach and traditional approach respectively. The operation time,intraoperative blood loss,and hospital stay were recorded;visual analogue scale(VAS) and Oswestry Disability Index (ODI) before and after operation were compared between two groups;spinal canal arca,spinal canal diameter,disc yellow space and surgical complications were observed.

Results: All 80 patients were followed up for at least 3 months. Two patients had incision infection,both of them were in traditional group;there was no significant difference in operation time between two groups(P>0.05). Intraoperative blood loss and hospital stay in study group were lower than those in traditional group(P<0.05). At 1 week and 3 months after operation,VAS and ODI of all patients were significantly lower than before operation(P<0.05),but the difference between two groups was not statistically significant(P>0.05). At 3 months after surgery,measured values of spinal canal area and spinal canal diameter were larger in study group than in traditional group(P<0.05). The operative complication rate of the study group was 5.00% compared with 12.50% of the traditional group,and the difference was not statistically significant(P>0.05).

Conclusion: Compared with the traditional approach,the modified interlaminar approach has advantages of less trauma,faster recovery and better postoperative spinal space recovery in the treatment of single-segment lumbar spinal stenosis.
KEYWORDS:Spinal stenosis  Endoscopes  Surgical approach  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:董振宇,周瑜博,黄异飞.改良经椎板间入路与传统入路治疗单节段腰椎椎管狭窄症的病例对照研究[J].中国骨伤,2021,34(4):337~340
英文格式:DONG Zhen-yu,ZHOU Yu-bo,HUANG Yi-fei.Case-control study on the treatment of single-segment lumbar spinal stenosis with modified interlaminar approach and traditional approach[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(4):337~340
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