[1]李龙付* 吴发林 胡睿 张晓宇 王高军 陈磊.改良侧入路椎间孔镜技术治疗L5/S1节段椎管狭窄症[J].中国微创外科杂志,2020,01(2):138-159.
　Li Longfu,Wu Falin,Hu Rui,et al.Modified Percutaneous Endoscopic Lumbar Discectomy via Lateral Approach for L5/S1 Spinal Stenosis[J].Chinese Journal of Minimally Invasive Surgery,2020,01(2):138-159.
点击复制

改良侧入路椎间孔镜技术治疗L5/S1节段椎管狭窄症()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年2期
页码:
138-159
栏目:
临床研究
出版日期:
2020-02-28

文章信息/Info

Title:
Modified Percutaneous Endoscopic Lumbar Discectomy via Lateral Approach for L5/S1 Spinal Stenosis
作者:
李龙付* 吴发林 胡睿 张晓宇 王高军 陈磊
（浙江湖州邦尔骨科医院骨科，湖州313002）
Author(s):
Li Longfu;  Wu Falin;  Hu Rui;  et al.
Department of Orthopeadics, Huzhou Bang’er Orthopaedic Hospital, Huzhou 313002, China
关键词:
椎管狭窄;  椎管减压; L5/S1; 经皮椎间孔镜技术
Keywords:
Spinal stenosis; Laminectomy; L5/S1 level; Percutaneous endoscopic lumbar discectomy
文献标志码:
A
摘要:
目的探讨采用改良侧入路经皮椎间孔镜技术（percutaneous endoscopic lumbar discectomy，PELD）治疗L5/S1节段椎管狭窄症的安全性及有效性。方法2014年4月~2018年6月，采用改良侧入路PELD治疗L5/S1椎管狭窄症34例。用2 mm克氏针穿刺，环锯结合骨钻进行椎间孔成形，多种操作工具进行椎管内成形。结果手术时间（81.9±15.8）min，均获得6~12个月随访，平均8.1月。根据改良MacNab标准，优22例，良9例，可3例，优良率91.2%。术后1周、1个月及末次随访时腰痛、腿痛视觉模拟评分（Visual Analogue Scale，VAS）及Oswestry功能障碍指数（Oswestry Disability Index，ODI）较术前均有显著改善（P<0.01）。结论采用改良侧入路PELD技术治疗L5/S1节段椎管狭窄症效果确切，短期疗效良好。
Abstract:
ObjectiveTo determine the safety and effecacy of modified percutaneous endoscopic lumbar discectomy (PELD) via lateral approach for the surgical treatment of L5/S1 lumbar spinal stenosis.MethodsA retrospective review was performed on 34 patients with L5/S1 lumbar spinal stenosis between April 2014 and June 2018. During the operation, a 2mm Kirschner wire was used for percutaneous puncture. The circular saw combined with bone resmers was used for intervertebral foraminoplasty, and various operating tools for lumbar laminoplasty. ResultsThe mean operative time was (81.9±15.8) min. The mean followup period was 8.1 (range, 6-12) months. According to the modified MacNab criteria, the therapeutic outcome was excellent in 22 cases, good in 9 cases, and fair in 3 cases, the excellent and good rate being 91.2%. Compared with the preoperative scores, the postoperative Visual Analogue Scale (VAS) scores of low back pain and leg pain and Oswestry Disability Index (ODI) scores at 1 week, 1 month and the final followup were significantly improved, which showed statistical significance (P<0.01).ConclusionModifed percutaneous endoscopic lumbar discectomy via lateral approach is an effective surgical method for L5/S1 lumbar spinal stenosis, which can achieve good shortterm results.

参考文献/References:

[1]Schroeder GD，Kepler CK，Kurd MF，et al.Rationale for the surgical treatment of lumbar degenerative spondylolisthesis.Spine (Phila Pa 1976)，2015，40(21):E1161-E1166.
[2]Farrokhi MR,Yadollahikhales G,Gholami M,et al.Clinical outcomes of posterolateral fusion vs. posteror lumbar interbody fusion in patients with lumbar spinal stenosis and degenerative instability.Pain Physician,2018,21(14):383-406.
[3]高琨，杨浩，刘亮，等.椎间孔镜BEIS技术与TLIF手术治疗老年腰椎管狭窄症的疗效比较.中国骨与关节损伤杂志，2019，34（1）：13-16.
[4]Li ZZ,Hou SX,Shang WL,et al.The strategy and early clinical outcome of fullendoscopic L5/S1 discectomy through interlaminar approach.Clin Neurol Neurosurg,2015,133：40-45.
[5]Schizas C,Theumann N,Burn A,et al.Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images.Spine (Phila Pa 1976),2010,35(21):1919-1924.
[6]Nellensteijn J，Ostelo R，Bsrtels R，et al.Tnansforaminal endoscopic surgery for symptomatic lumbar disc herniations：a systematic review of the literature.Eur Spine，2010，19(2):181-204.
[7]李新武，韦文，赵勇.青少年L4/5和L5/S1椎间盘突出症的相关形态学和解剖学参数的影像学研究.中国医药导报，2016，13（33）：88-91.
[8]Cassinelli EH,Eubanks J,Vogt M,et al.Risk factors for the development of perioperative complications in elderly patients undergoing lumbar decompression and arthrodesis for spinal stenosis:an analysis of 166 patients.Spine (Phila Pa 1976),2007,32(2):230-235.
[9]周跃,李长青,王建,等.经皮椎间孔成形术治疗L5/S1神经根管狭窄症.中国脊柱脊髓杂志,2009,19(5):345-349.
[10]程才，辛大森，王路,等.椎间孔镜TESSYS技术治疗单责任节段腰椎管狭窄症的近期效果.中国微创外科杂志，2018，18（10）：920-923.
[11]Gun C,Song HL,Pramod L,et al.Percutaneous endoscopic approach for highly migrated intracanal disc herniatious by foraminoplastic technique using rigid working channel endoscope.Spine,2008,33(15):E508-E515.
[12]刘丰平，赵红卫，董军峰,等.后外侧入路椎间孔镜下L5S1椎间盘突出伴高髂嵴髓核摘除术的技术改进.中国微创外科杂志，2019，19（2）:101-105.
[13]祝乃强，侯静怡，马桂云,等.改良TESSYS技术治疗老年性退变性腰椎管狭窄症的疗效分析.中国骨与关节杂志，2017,6(10):780-785.

备注/Memo

备注/Memo:
*通讯作者，Email：13915422869@139.com
更新日期/Last Update: 2020-05-16