经皮椎间孔镜技术与Quadrant可扩张管通道系统技术治疗单节段腰椎管狭窄症的临床疗效比较

The clinical effect contrast observation of percutaneous transforaminal technique and quadrant expandable channel system technology in the treatment of single-segment lumbar spinal stenosis

目的对比观察经皮椎间孔镜技术和Quadrant可扩张管通道系统技术治疗单节段腰椎管狭窄症的临床疗效。方法回顾性分析单节段腰椎管狭窄症患者64例,将其中采用Quadrant可扩张管通道系统技术治疗的32例患者设为A组,将采用经皮椎间孔镜技术治疗的32例患者设为B组。比较2组的切口长度、手术时间、术中出血量、术后下地时间、住院时间以及相关并发症。并采用视觉模拟评分(VAS)评估患者术前、术后疼痛情况,Oswesty功能障碍指数评分(ODI)评价疗效。结果 B组患者切口长度短于A组,手术时间短于A组,术中出血量小于A组,差异均有统计学意义(P<0.05)。2组术后下地时间、住院时间比较差异均无统计学意义(P>0.05),2组患者术后平均随访20.6个月(18~24个月),2组患者均未见明显手术并发症。2组患者术后VAS及ODI评分均较术前有明显改善,差异均有统计学意义(P<0.05),2组间术前、术后3 d及术后3个月VAS及ODI评分的差异无统计学意义(P>0.05)。结论经皮椎间孔镜技术具有手术切口更短、手术时间更少、术中出血更少等优点,该技术在治疗单节段腰椎管狭窄症上可以取得与Quadrant可扩张管通道系统技术相同的临床疗效,是一种安全有效的微创手术。

Objective To contrast observation the clinical effect of percutaneous transforaminal technique and quadrant expandable channel system technology in the treatment of single-segment lumbar spinal stenosis. Methods The clinical data of 64 cases patients with single-segment lumbar spinal stenosis analysed retrospectively. 32 patients treated with the Quadrant expandable canal system were assigned as group A,and 32 patients treated with percutaneous transthoracic surgery were assigned to group B. After treatment,the cut length,operation time,intraoperative blood loss,postoperative time to the ground,length of hospitalization between the two groups were compared. The visual analogue scale（ VAS） was used to evaluate the preoperative and postoperative pain status. Oswesty dysfunction score（ ODI） was used to evaluate efficacy. Results The cut length and operation time of group B was shorter than that of group A,and the intraoperative blood loss of group B was less than that of group A,the differences were statistic significantly（ P 〈0. 05）. The differences of the ambulation time after the operation and length of hospitalization between two groups were no statistic significantly（ P 〉0. 05）. The average follow-up was 20. 6months（ 18 ~ 24 months）,and there was no significant operative complication in the two groups. After operation,the VAS and ODI scores of the two groups had improved than before operation,the differences were statistic significantly（ P 〈0. 05）. There was no significant difference in VAS and ODI scores between the two groups before operation,3 days after operation and 3months after operation（ P 〉0. 05）. Conclusion Percutaneous foramina technique has the advantages of shorter operative incision,less operative time,less intraoperative bleeding,etc. The technology in the treatment of single-segment lumbar spinal stenosis can be achieve the same clinical efficacy as quadrant expandable duct system technology,whitch is a safe and effective minimally invasive surgery.