内镜与开放双侧减压治疗老年腰椎管狭窄症
Endoscopic versus open bilateral decompression for lumbar spinal stenosis in elderly
汤玮 1丁兆利 1潘伟 1韩庆龙 1周东生2
作者信息
- 1. 日照市第二人民医院骨科,山东日照 276807
- 2. 山东省立医院骨科,山东济南 250000
- 折叠
摘要
[目的]比较 Endo-Surgi Plus 脊柱内镜单侧入路双侧减压技术(endoscopic unilateral laminotomy and bilateral decom-pression,Endo-ULBD)与开放双侧减压治疗老年腰椎管狭窄症患者的临床疗效.[方法]2018年12月-2020年12月在本院手术治疗的51例腰椎管狭窄症患者纳入本研究,根据医患沟通结果,将患者分为内镜组(31例),开放组(20例).比较两组临床和影像结果.[结果]所有患者均顺利完成手术,内镜组手术时间[(73.2±21.0)min vs(178.4±22.9)min,P＜0.001]、术中出血量[(7.1±3.6)ml vs(220.0±140.9)ml,P＜0.001]、术后下地时间[(1.5±0.4)d vs(6.4±1.8)d,P＜0.001]、住院时间[(3.0±1.2)d vs(9.4±3.1)d,P＜0.001]均显著少于开放组.随时间推移,两组腰痛、腿痛VAS评分、ODI评分均显著改善(P＜0.05),相应时间点,两组间上述指标的差异均无统计学意义(P＞0.05).末次随访两组MacNab优良率的差异无统计学意义(P＞0.05).与术前相比,末次随访时,两组椎间隙高度无显著变化(P＞0.05),硬膜囊横截面积显著增加(P＜0.05).相应时间点,两组间上述影像指标的差异均无统计学意义(P＞0.05).[结论]Endo-ULBD治疗老年腰椎管狭窄症,具有安全、微创、康复快等优点,且疗效与开放手术相当,短期临床疗效好.
Abstract
[Objective]To compare the clinical outcomes of endoscopic unilateral laminotomy and bilateral decompression(Endo-ULBD)with Endo-Surgi Plus endoscope versus open bilateral decompression for lumbar spinal stenosis in the elderly.[Methods]A retro-spective study was done on 51 patients who received surgical treatment for lumbar spinal stenosis in our hospital from December 2018 to De-cember 2020.According to the doctor-patient communication,31 patients underwent the endoscopic decompression,while other 20 patients had the conventional open decompression.The clinical and imaging data were compared between the two groups.[Results]All patients in both groups had operation performed successfully.The endoscopic group was significantly superior to the open group in terms of operation time[(73.2±21.0)min vs(178.4±22.9)min,P＜0.001],intraoperative blood loss[(7.1±3.6)ml vs(220.0±140.9)ml,P＜0.001],postoperative bed rest time[(1.5±0.4)days vs(6.4±1.8)days,P＜0.001],and hospital stay[(3.0±1.2)days vs(9.4±3.1)days,P＜0.001].As time went by,the VAS scores of low back pain and leg pain,as well as ODI score in the two groups were significantly improved(P＜0.05),which were not statis-tically significant between the two groups at any corresponding time points(P＞0.05).At the last follow-up,there was no significant differ-ence in MacNab excellent and good rate between the two groups(P＞0.05).At the last follow-up,there was no significant change in vertebral space height(P＞0.05),while the dural sac cross-sectional area was significantly increased in both groups compared with those before opera-tion(P＜0.05).At corresponding time points,there were no significant differences in the above image indicators between the two groups(P＞0.05).[Conclusion]The Endo-ULBD achieve good short-term clinical consequence comparable to the open surgery,while has the advan-tages of minimally invasive surgery and rapid recovery for lumbar spinal stenosis in the elderly.
关键词
Endo-Surgi/Plus脊柱内镜单侧入路双侧减压技术(Endo-ULBD)/腰椎管狭窄症/可视化环锯Key words
Endo-Surgi Plus Spinal endoscopic unilateral approach and bilateral decompression technique(Endo-ULBD)/lumbar spinal stenosis/visual trephine引用本文复制引用
出版年
2024
NETL
NSTL
万方数据