[1]陈华,董石磊,李琳,等.单孔分体内镜技术辅助下单侧入路双侧减压治疗退变性腰椎管狭窄症的早期疗效观察[J].中国中医骨伤科杂志,2024,32(12):87-91.[doi:10.20085/j.cnki.issn1005-0205.241217 ]
　XIAO Qiangbing,XU Yangping,ZHAO Shuyan,et al.CHEN Hua1,2,3 DONG Shilei1,2,3 LI Lin1,2,3 ZHANG Jing1,2,3 ZHANG Xin1,2,3[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(12):87-91.[doi:10.20085/j.cnki.issn1005-0205.241217 ]
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单孔分体内镜技术辅助下单侧入路双侧减压治疗退变性腰椎管狭窄症的早期疗效观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年12期
页码:
87-91
栏目:
临床报道
出版日期:
2024-12-15

文章信息/Info

Title:
CHEN Hua1,2,3 DONG Shilei1,2,3 LI Lin1,2,3 ZHANG Jing1,2,3 ZHANG Xin1,2,3
文章编号:
1005-0205(2024)12-0087-05
作者:
陈华1; 2; 3; 董石磊1; 2; 3; 李琳1; 2; 3; 张靖1; 2; 3; 张鑫1; 2; 3; 肖强兵1; 2; 3; 徐阳平1; 2; 3; 赵述艳1; 2; 3△; 李峰1; 2; 3△
1湖北省中医院(武汉,430074)
2湖北中医药大学附属医院
3湖北省中医药研究院
Author(s):
XIAO Qiangbing1; 2; 3; XU Yangping1; 2; 3; ZHAO Shuyan1; 2; 3△; LI Feng1; 2; 3△
1Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430074,China; 2Affiliated Hospital of Hubei University of Chinese Medicine,Wuhan 430074,China; 3Hubei Province Academy of Traditional Chinese Medicine,Wuhan
关键词:
单孔分体内镜;  单侧入路双侧减压;  退变性腰椎管狭窄症
Keywords:
one-hole split endoscope;  unilateral laminotomy with bilateral decompression;  degenerative lumbar canal stenosis
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.241217
文献标志码:
B
摘要:
目的:探讨单孔分体内镜(OSE)技术辅助下单侧入路双侧减压(ULBD)治疗退变性腰椎管狭窄症(DLCS)的临床疗效。方法:纳入2023年6月至2024年2月收治的70例退变性腰椎管狭窄症患者,其中男42例,女28例; 平均年龄为(70.2±10.8)岁; 单节段减压50例,双节段减压20例,共90个节段减压。病椎节段:L3/4节段10例次,L4/5节段50例次,L5S1节段30例次。均采用单孔分体内镜辅助下单侧入路双侧减压方式减压治疗,记录术中观察指标及并发症,比较术前、术后3 d及末次随访的Oswestry功能障碍指数(ODI)和腰腿疼痛视觉模拟量表(VAS)评分,术后6个月采用改良MacNab评分评估疗效。结果:手术时间为(94.6±21.2)min,平均随访(9.3±3.5)个月,术中发生1例硬膜囊撕裂,术后1例下肢肌力稍下降,3例腰骶部疼痛放射至下肢。与术前比较,术后3 d和末次随访的ODI评分及腰腿疼痛VAS评分均下降,差异有统计学意义(P<0.05),手术优良率为92.86%。结论:单孔分体内镜技术辅助下单侧入路双侧减压手术方式治疗退变性腰椎管狭窄症创伤小,恢复更快,手术安全性更高,术中减压效果更确切,是治疗双侧症状退变性腰椎管狭窄症的有效微创术式。
Abstract:
Objective:To observe the clinical efficacy of unilateral laminotomy with bilateral decompression(ULBD)in the treatment of degenerative lumbar canal stenosis(DLCS)under one-hole split endoscope(OSE).Methods:70 patients with DLCS were included from June 2023 to February 2024.Of the 70 patients,42 were males,and 28 females.The average ages were(70.2±10.8)years old.50 cases received unilateral segmental decompression,and another 20 underwent bilateral segmental decompression(decompression was done in a total of 90 segments).The diseased segment included 10 cases at L3/4,50 cases at L4/5,and 30 cases at L5S1.All patients underwent ULBD under OSE.The related intraoperative indicators as well as complications were recorded,and comparison was made regarding the Oswestry disability index(ODI)and visual analogue scale(VAS)scores for waist and leg pain before operation,3 d after operation,and at final follow-up after surgery.Modified MacNab criteria were used to evaluate satisfaction with the surgery by the 6 months after operation.Results:The surgery was successfully completed in all patients.The operative time,and average days of follow-up were(94.6±21.2)min,and(9.3±3.5)months,respectively.Intraoperative tear of duralsac occurred in 1 case.One patient was complicated with muscle strength decrease after operation,and another 3 patients with residual lumbosacral pain.ODI scores and VAS scores for waist and leg were significantly decreased at 3 d after surgery and final follow-up after surgery compared to the indicators observed before operation(P<0.05).The excellent and good rates were 92.86% for the operation.Conclusion:ULBD under OSE possesses less trauma,fast recovery and higher safety in the treatment of DLCS.In addition,the decompression is effective by this minimally invasive surgery.

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备注/Memo

备注/Memo:
△通信作者 E-mail:814270350@qq.com(赵述艳) 690683196@qq.com(李峰)
更新日期/Last Update: 2024-12-05