[1]王永康.全可视内镜引导下单侧入路双侧减压术治疗腰椎管狭窄症[J].中国临床神经外科杂志,2023,28(12):685-688692.[doi:10.13798/j.issn.1009-153X.2023.12.004]
　WANG Yong-kang.Clinical efficacy and safety of endoscopic unilateral laminotomy and bilateral decompression for patients with lumbar spinal stenosis[J].,2023,28(12):685-688692.[doi:10.13798/j.issn.1009-153X.2023.12.004]
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全可视内镜引导下单侧入路双侧减压术治疗腰椎管狭窄症()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年12期
页码:
685-688692
栏目:
论著
出版日期:
2023-12-31

文章信息/Info

Title:
Clinical efficacy and safety of endoscopic unilateral laminotomy and bilateral decompression for patients with lumbar spinal stenosis
文章编号:
1009-153X（2023）12-0685-04
作者:
王永康
255000山东，淄博市中医医院（淄博市骨科医院）脊柱外科（王永康）
Author(s):
WANG Yong-kang
Department of Spinal Surgery, Zibo Orthopedics Hospital, Zibo 255000, China
关键词:
腰椎管狭窄症; 全可视内镜引导下单侧入路双侧减压术; 疗效
Keywords:
Lumbar spinal stenosis;  Endoscopic unilateral laminotomy and bilateral decompression;  Safety;  Efficacy
分类号:
R 681.5+7; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2023.12.004
文献标志码:
A
摘要:
目的 探讨全可视内镜引导下单侧入路双侧减压术（Endo-ULBD）治疗腰椎狭窄症（LSS）的安全性及有效性。方法 回顾性分析2020年6月至2022年6月行Endo-ULBD治疗的46例LSS的临床资料。术前以及术后1 d、3个月、6个月、12个月采用视觉模拟量表（VAS）评分、Oswestry 功能障碍指数（ODI）评估临床疗效，采用改良MacNab评分标准评定优良率。结果 所有病例均按计划顺利实施手术，手术时间50~90 min，平均（60.23±12.95）min；术中出血量15~40 ml，平均（21±4.21）ml；术后住院天数3~8 d，平均（5.2±1.58）d；随访时间10~24个月，平均（14±8.45）个月。ODI术后1 d较术前明显下降（P<0.001），术后3、6、12个月较术后1 d又明显下降（P<0.05）。腰部、腿部VAS评分术后1 d较术前均明显下降（P<0.05），腰部VAS评分术后3、6、12个月较术后1 d无明显变化（P>0.05），但是腿部VAS评分术后3、6、12个月较术后1 d明显下降（P<0.05）。末次随访，按MacNab标准，优良率为91.3%；术后CT、MRI及X线检查显示病变节段椎管狭窄情况明显改善。术后出现一过性神经损伤1例，硬膜囊撕裂1例，复发1例；并发症发生率为6.5%。结论 Endo-ULBD能有效地完成腰椎管减压，是一种安全、有效的治疗LSS的手术方式。
Abstract:
Objective To investigate the safety and efficacy of endoscopic unilateral laminotomy and bilateral decompression (Endo-ULBD) for patients with lumbar spinal stenosis (LSS). Methods The clinical data of 46 patients with LSS treated with Endo-ULBD from June 2020 to June 2022 were retrospectively analyzed. Visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the clinical efficacy before surgery and 1 d, 3 months, 6 months and 12 months after surgery. Modified MacNab score was used to evaluate the excellent and good rate. Results All patients were operated successfully. The operation time was 50~90 min, and the average time was (60.23±12.95) min. Intraoperative blood loss was 15~40 ml, with an average of (21±4.21) ml. Postoperative hospitalization days ranged from 3 to 8 days, with an average of (5.2±1.58) days. The average follow-up time was (14±8.45) months (range, 10~24 months). The ODI was significantly lower 1 day after surgery than that before surgery (P<0.001), and the ODIs were dignificantly lower 3, 6 and 12 months after surgery than 1 d day after surgery (P<0.05). The lumbar and the leg VAS scores were significantly decreased 1 day after surgery (P<0.05). The leg VAS score was significantly lower 3, 6 and 12 months after surgery than that 1 day after surgery (P<0.05), but the lumbar VAS score did not significantly change 3, 6 and 12 months after surgery (P>0.05). At the last follow-up, the excellent and good rate was 91.3% according to the MacNab standard. Postoperative CT, MRI and X-ray examination showed that the spinal stenoses were significantly improved. Transient nerve injury occurred in 1 patient, dural sac tear injury in 1 and recurrence in 1. The complication rate was 6.5%. Conclusions Endo-ULBD can effectively decompress lumbar spinal canal and is a safe and effective surgical method for patients with LSS.

参考文献/References:

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备注/Memo

备注/Memo:
（2023-07-22收稿，2023-09-09修回）
基金项目：淄博市医药卫生科研项目（20230407054）
更新日期/Last Update: 2023-12-31