| 经皮脊柱内镜治疗退变性腰椎管狭窄症的现状及进展 |
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Received:March 07, 2021
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| 期刊信息：《中国骨伤》2022年35卷，第4期，第400-404页 |
| DOI：10.12200/j.issn.1003-0034.2022.04.019 |
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| 经皮脊柱内镜减压术(percutaneous spinal endoscopic decompression,PSED)近些年在治疗退变性腰椎管狭窄(degenerative lumbar spinal stenosis,DLSS)中取得了良好的效果。相对于传统的开放手术创伤大、出血多、术后患者需较长时间卧床,恢复慢,PSED技术的迅速发展,很大程度上减少了DLSS患者的手术创伤、术后恢复时间和并发症。以PSED核心为靶点的治疗方法,以最小的创伤同时达到满意的腰椎管狭窄症的减压效果。根据腰椎管狭窄的位置和程度,确定理想的治疗方法至关重要。然而,在实践中,存在PSED对不同病理类型腰椎管狭窄症的治疗认识不足,如适应证选择、手术入路选择、各种入路的优缺点、内镜下椎体融合等问题。目前随着人们对PSED研究的深入及内镜器械的改进,在治疗DLSS方面取得了较大进展。本文将从适应证的把握、入路途径的选择、内镜入路的优劣点以及内镜辅助下椎体融合4个方面阐述PSED治疗DLSS的研究进展,以期为PSED临床治疗DLSS提供一定的指导。 |
| [关键词]:内镜减压 腰椎 椎管狭窄 最小侵入性外科手术 |
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| Current status and progress of percutaneous spinal endoscopy in the treatment of degenerative lumbar spinal stenosis |
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| Abstract:Percutaneous endoscopic spine decompression(PSED) in recent years in the treatment of degenerative lumbar spinal stenosis(DLSS) achieved excellent results.Compared with traditional open surgery,which is characterized by large trauma,much bleeding,longer bed stay and slow recovery,the rapid development of PSED technology has greatly reduced the surgical trauma,postoperative recovery time and complications of DLSS patients. PSED core as the target therapy,with minimal trauma at the same time to achieve satisfactory decompression effect for lumbar spinal stenosis. Depending on the level,location,and degree of lumbar spinal stenosis,it is important to determine the ideal treatment. However,in practice,PSED has insufficient understanding of the treatment of different pathological types of lumbar spinal stenosis,such as indication selection,surgical approach selection,advantages and limitations of various approaches,and endoscopic vertebral fusion.At present,with the deepening of PSED research and the improvement of endoscopic instruments,great progress has been made in the treatment of DLSS.In this paper,the research progress in the treatment of DLSS by PSED in recent years will be described from four aspects,namely,the grasp of indications,the selection of approaches,the advantages and disadvantages of endoscopic approaches,and endoscope-assisted vertebral fusion,in order to provide certain guidance for the clinical treatment of DLSS by PSED. |
| KEYWORDS:Endoscopic decompression Lumbar vertebrae Spinal stenosis Minimally invasive surgical procedures |
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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.经皮脊柱内镜治疗退变性腰椎管狭窄症的现状及进展[J].中国骨伤,2022,35(4):400~404 |
| 英文格式: | SHI Fu-dong,ZHANG Shi-min.Current status and progress of percutaneous spinal endoscopy in the treatment of degenerative lumbar spinal stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(4):400~404 |
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