摘要
目的 单侧双通道内镜技术治疗腰椎管狭窄症是近年来新兴的微创方式。文中旨在探讨单侧双通道脊柱内镜技术(UBE)治疗腰椎管狭窄症的临床疗效。方法 回顾性分析2020年1月至12月东部战区总医院骨科收治的30例腰椎管狭窄症患者临床资料。所有患者均行UBE,通过记录患者手术时间、出血量、术后引流量等评估其安全性。比较术前、术后3天、术后3个月、术后6个月腰痛及下肢痛的视觉模拟评分(VAS)和Oswestry功能障碍指(ODI)以及改良的Macnab标准评估其临床疗效。结果 所有腰椎管狭窄症患者均在镜下顺利完成手术。术后6个月腰痛VAS评分[(1.43±0.53)分]较术前[(5.07±0.91)分]明显降低(P=0.000),下肢痛VAS评分[(2.23±0.56)分]较术前[(7.36±0.81)分]明显降低(P=0.000),ODI较术前明显降低(P=0.000)。改良Macnab评价标准结果显示,优19例,良7例,可4例,优良率为86.7%。结论 UBE可有效解除中央管及侧椎管狭窄并显著缓解患者临床症状,明显改善生活质量,是治疗腰椎管狭窄症的安全可行方法。
Objective Unilateral biportal endoscopic spine surgery(UBESS) is a recently emerging minimally invasive surgery treatment. This study has a purpose to explore its clinical efficacy in treatment of lumbar spinal stenosis(LSS). Methods 30 patients with LSS admitted to our department from January 2020 to December 2020 were enrolled to this retrospective study. All patients underwent UBESS. Clinical data such as incision size, operation time, blood loss, postoperative drainage was collected to evaluate its safety. Visual analog scale(VAS) for low back pain and lower extremity pain before operation, 3 days after operation, 3 and 6 months after operation, as well as the Oswestry dysfunction index(ODI) and the modified Macnab standard were examined to probe the clinical benefits. Results All LSS patients completed the operation under the microscope successfully. The VAS score for low back pain decreased from preoperative(5.07±0.91) to 6 months after surgery(1.43±0.53)(P=0.000);the VAS score for lower limb pain reduced from preoperative(7.36±0.81) to 6 months after the operation(2.23±0.56)(P=0.000);ODI also showed stark drop after operation(P=0.000). The modified Macnab criteria suggested that 19 cases were excellent, 7 cases were good, 4 cases were fair and the excellent and good rate was 86.7%. Conclusion UBESS can well ease stenosis and lateral stenosis and eminently relieve patients’ clinical symptoms, thereby improve their quality of life. It is a safe and valid treatment for LSS.
作者
何鹏
刘晓伟
王彬
武振方
丛宇
许斌
HE Peng;LIU Xiao-wei;WANG Bin;WU Zhen-fang;CONG Yu;XU Bin(Department of Orthopaedic,Jingling Hosptal,Nanjing University School of Medicine/General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)
出处
《医学研究生学报》
CAS
北大核心
2022年第3期303-306,共4页
Journal of Medical Postgraduates
基金
江苏省卫生健康委科研项目面上基金(H2019022)。
关键词
单侧双通道脊柱内镜技术
腰椎管狭窄症
微创
unilateral biportal endoscopic spine surgery
lumbar spinal stenosis
minimally invasive
作者简介
何鹏,医学博士研究生;通信作者:许斌,E-mail:jzwkxubin@163.com。
