Self-made Minimally Invasive Hook Assisted Microscopy for Unilateral and Bilateral Decompression Treatment of Lumbar Spinal Stenosis
Objective To investigate the clinical benefits of utilizing a self-made minimally invasive hook in conjunction with a microscope for unilateral and bilateral decompression in the management of lumbar spinal stenosis(LSS).Methods Totally,46 patients diagnosed with LSS requiring surgical treatment were selected from a total of 238 patients in our hospital from June 2022 to June 2023.They were randomly assigned to either the experimental group,which underwent minimally invasive hook-assisted microendoscopic unilateral approach bilateral decompression surgery(observation group),or the control group,which underwent traditional bilateral decompression surgery.The observation group consisted of 10 male and 13 female patients with age of(58.74±9.77)years,while the control group had 11 male and 12 female patients with age of(60.65±7.99)years.The surgical time,amount of blood loss,perioperative levels of C-reactive protein(CRP)and serum creatine kinase(CK),visual analogue score(VAS),Oswestry Disability Index(ODI),modified MacNab criteria score,as well as the pre-and post-operative dural sac area and intervertebral space height were recorded and compared between the two groups.Results Both groups of patients underwent surgery smoothly,with no changes in surgical cases due to special reasons during the procedure.All patients were followed up for a period of(8.00± 2.96)months(ranging from 4 to 13 months).The observation group had significantly less intraoperative blood loss than the control group[(148.70±42.35)mL vs.(215.22±60.14)mL](P＜0.05).The postoperative CRP and CK levels in both groups at 2 days after surgery showed significant improvement compared to preoperative levels,with the observation group showing lower values than the control group[(7.32±0.92)vs.(11.35±1.59)mg/L,(237.70±45.64)vs.(384.26±78.49)U/L],and the difference was statistically significant(P＜0.05).The VAS scores and ODI in both groups at 2 days,1 month,and 3 months postoperatively were significantly decreased compared to preoperative values,with statistical significance(P＜0.05).Additionally,when comparing the data at 2 days postoperatively between the two groups,the observation group had lower scores than the control group[2.78±0.67 vs.4.04±0.82,14.96％±2.50％vs.19.26％±4.32％],and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the modified MacNab scores at various postoperative stages between the two groups(P＞0.05).The dural sac area and intervertebral space height were significantly increased postoperatively compared to preoperative values in both groups.The dural sac area in the control group at 2 days and 1 month postoperatively was greater than that in the observation group[(160.92± 7.17)vs.(148.86±8.59)mm2,(159.44±7.02)vs.(147.70±8.40)mm2],and the difference was statistically significant(P＜0.05),while there was no statistically significant difference in the intervertebral space height between the two groups postoperatively(P＞0.05).Conclusion The utilization of a self-designed minimally invasive hook-assisted approach under a microscope for unilateral approach bilateral decompression in treating LSS has been proven to be safe and effective.This surgical method is minimally invasive,resulting in reduced blood loss and minimal tissue damage,making it a promising technique worthy of wider adoption.
LumbarMinimally invasive hookMicroscopeBilateral decompression with unilateral approachSpinal stenosis
万方数据
维普
