摘要
目的 对比脊柱内镜下单侧椎板间入路双侧椎管减压(Endo-ULBD)术与全脊柱内镜下椎板开窗减压(Endo-LOVE)术在治疗双节段腰椎管狭窄症(LSS)中的临床疗效.方法 回顾性分析2020年1月至2023年7月在云南省第三人民医院诊治的腰椎管狭窄症112例患者临床资料,根据手术方式分为ULBD组(n=54)和LOVE组(n=58).ULBD组行Endo-ULBD术,LOVE组行Endo-LOVE术,于术后1、3、6个月进行门诊随访,比较两组患者术后恢复情况.结果 LOVE组的手术耗时短于ULBD组,术中透视次数少于ULBD组(P＜0.05).治疗前(T1)两组的视觉模拟评分表(VAS)评分比较,差异无统计学意义(P＞0.05);两组术后1个月(T2)～6个月(T4)的VAS评分低于T1(P＜0.05),且两组T2～T4的VAS评分比较,差异无统计学意义(P＞0.05).两组T1的Oswestry功能障碍指数(ODI)评分比较,差异无统计学意义(P＞0.05);两组T2～T4的ODI评分低于T1(P＜0.05),两组T3和T4的ODI评分比较,差异无统计学意义(P＞0.05),LOVE组T2的ODI评分高于ULBD组(P＜0.05).末次随访时两组进行腰椎功能优良率比较,差异无统计学意义(P＞0.05).两组术后及随访期间的并发症发生率比较,差异无统计学意义(P＞0.05).结论 Endo-ULBD术与Endo-LOVE术治疗双节段LSS效果相当,前者短期内腰椎功能改善更佳,后者手术耗时短、术中透视次数少.
Abstract
Objective To compare the clinical efficacy of endoscopic unilateral interlaminal decompression(Endo-ULBD)and endoscopic window decompression(Endo-LOVE)in the treatment of two-level lumbar spinal stenosis(LSS).Methods 112 patients with lumbar spinal stenosis in the hospital were selected(January 2020 to July 2023).The patients were divided into ULBD group(n=54)and LOVE group(n=58)according to the operation method.Endo-ULBD was performed in the ULBD group,and Endo-LOVE was performed in the LOVE group.Outpatient follow-up was performed 1,3 and 6 months after the sur-gery.The postoperative recovery of the 2 groups was compared.Results The operation time of LOVE group was shorter than that of ULBD group,and the intraoperative fluoroscopy times were less than that of ULBD group(P＜0.05).Before the treatment(T1),there was no significant difference in visual ana-logue scale(VAS)scores between the 2 groups(P＞0.05).VAS scores at 1 month(T2)～6 months(T4)were lower than those at T1(P＜0.05).There was no significant difference in the VAS scores of T2～T4 between the 2 groups after the operation(P＞0.05).There was no significant difference in Oswe-stry Disability Index(ODI)scores between the 2 groups T1(P＞0.05).The postoperative ODI scores of T2 to T4 were lower than those of T1(P＜0.05),and there was no statistical significance in the postoper-ative ODI scores of T3 and T4 between the 2 groups(P＞0.05),while the T2 ODI scores of LOVE group were higher than those of ULBD group(P＜0.05).At the last follow-up,there was no significant differ-ence in the rate of excellent and good lumbar function between the 2 groups(P＞0.05).There was no sig-nificant difference in the incidence of complications between the 2 groups after the surgery and during fol-low-up(P＞0.05).Conclusion Endo-ULBD and Endo-LOVE have similar efficacy in the treatment of two-level LSS.The former has better short-term improvement of lumbar function,while the latter has shorter operation time and fewer intraoperative fluoroscopy times.
基金项目
云南省医学研究科技计划项目(2020FE4623)
NETL
NSTL
万方数据