[1]薛静波 陈浩翔 李学林 欧阳智华 王程 晏怡果**.经皮全脊柱内镜经椎板间隙入路治疗中央型腰椎管狭窄症[J].中国微创外科杂志,2020,01(4):322-329.
　Xue Jingbo,Chen Haoxiang,Li Xuelin,et al.Percutaneous Total Spinal Endoscopy for Treatment of Central Lumbar Spinal Stenosis by Interlaminar Approach[J].Chinese Journal of Minimally Invasive Surgery,2020,01(4):322-329.
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经皮全脊柱内镜经椎板间隙入路治疗中央型腰椎管狭窄症()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年4期
页码:
322-329
栏目:
临床研究
出版日期:
2020-04-25

文章信息/Info

Title:
Percutaneous Total Spinal Endoscopy for Treatment of Central Lumbar Spinal Stenosis by Interlaminar Approach
作者:
薛静波 陈浩翔 李学林 欧阳智华 王程 晏怡果**
(南华大学附属第一医院脊柱外科，衡阳421001)
Author(s):
Xue Jingbo;  Chen Haoxiang;  Li Xuelin;  et al.
Department of Spine Surgery, First Affiliated Hospital of University of South China, Hengyang 421001, China
关键词:
中央型腰椎管狭窄症; 全脊柱内镜; 脊柱手术
Keywords:
Central lumbar spinal stenosis; Total spinal endoscopy; Spinal surgery
文献标志码:
A
摘要:
目的探讨经皮全脊柱内镜经椎板间隙入路治疗单节段中央型腰椎管狭窄症的临床疗效。方法2016 年 1 月～2017 年 12 月我科对腰椎中央管狭窄在连续硬膜外麻醉下行经皮全脊柱内镜椎板间隙入路椎管扩大减压术，采用疼痛视觉模拟评分(Visual Analogue Scale，VAS)、Oswestry 功能障碍指数(Oswestry Disability Index，ODI)和MacNab标准评价疗效。结果26例均顺利完成手术。1例术中损伤撕裂硬膜囊，保守治疗后痊愈。1例术后出现单侧下肢一过性肌力下降，1例术后出现腰背部及双下肢疼痛症状。住院时间(6.4±2.1)d。腰痛术前VAS 评分(7.5±0.8)分，显著高于术后第1天(3.4±06)分和术后12个月(1.7±0.7)分(P均=0.000)。腿痛VAS评分术前(7.3±0.8)分，显著高于术后第1天(4.0±0.7)分和术后12个月(1.7±0.7)分(P均=0.000)。术前ODI(77.8±4.6)%，显著高于术后1 个月(45.4±4.6)%和术后12个月(8.8±2.9)%(P均=0.000)。术后12 个月采用MacNab 进行疗效评定：优14例,良10例,可 2 例,优良率 92.3%（24/26）。结论经皮全脊柱内镜经椎板间隙入路治疗单节段腰椎中央管狭窄症，手术风险低，临床疗效满意。
Abstract:
ObjectiveTo analyze the clinical efficacy of percutaneous total spine endoscopy in the treatment of singlesegment central lumbar spinal stenosis.MethodsTwentysix patients with central lumbar spinal stenosis were treated in our hospital from January 2016 to December 2017. All the patients were operated under continuous epidural anesthesia. The operation was performed by percutaneous endoscopic interlaminar approach for spinal canal enlargement and decompression. The operation time, postoperative complications, and hospitalization time were observed and counted. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the efficacy of the patients before and after surgery. The MacNab standard was used to evaluate the efficacy at 12 months postoperatively.ResultsTwentysix patients successfully underwent the operation, and one patient suffered from intraoperative injury to the dural sac. One of them had a transient lower extremity muscle strength after surgery and one patient developed symptoms of pain in the lower back and lower extremities after surgery. All patients were cured after conservative treatment. The hospitalization time of all patients was (6.4±2.1) d. The VAS score of low back pain was (7.5±0.8) points before operation, which was significantly higher than that on the first day after operation (3.4±0.6) points (P=0.000) and 12 months after operation (1.7±0.7) points (P=0.000). The VAS score of leg pain was (7.3±0.8) points before operation, which was significantly higher than that on the first day after operation (4.0±0.7) points (P=0.000), and 12 months after operation (1.7±0.7) points (P=0.000). The ODI was (77.8±4.6)% preoperatively，which was distinctly higher than that 1 month after operation(45.4±4.6)% (P=0.000) and 12 months after operation (8.8±2.9)% (P=0.000).The evaluation with the MacNab standard at 12 months postoperatively showed excellent in 14 cases, good in 10 cases, and moderate in 2 cases. The excellent and good rate was 92.3%(24/26). ConclusionPercutaneous total spinal endoscopy for the treatment of singlesegment central lumbar spinal stenosis has advantages of low surgical risk and satisfactory clinical results.

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备注/Memo

备注/Memo:
基金项目：湖南省临床医疗技术创新引导项目（2017SK50202，2017SK50201）；湖南省卫生计生委科研计划课题重点项目（A2017016）；湖南省科技厅计划项目（2017SK4004）；衡阳市科技计划项目（2018KJ115）；湖南省卫生计生委B类课题(20180154) ；湖南省卫生计生委科研计划课题（C2017093）**通讯作者，Email:yan_yiguo@qq.com
更新日期/Last Update: 2020-07-14