椎间孔镜治疗80岁以上腰椎管狭窄症患者疗效评价

Effect of transforaminal endoscopic spine surgery on lumbar spinal stenosis in elderly over 80 years old

背景:80岁以上腰椎管狭窄症患者因其疾病的复杂性与特殊性,加之并发多种内科疾病,需要十分谨慎地选择治疗方法。目的:评价椎间孔镜治疗80岁以上腰椎管狭窄症患者的疗效。方法:选择2012年11月至2017年12月椎间孔镜手术治疗老年腰椎管狭窄症患者52例进行回顾性分析。记录并比较患者术前、术后1个月、3个月、6个月及12个月疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和日本骨科协会(JOA)评分。结果:入选52例患者中,51例患者获得随访,随访时间24~60个月,平均随访时间(36.0±0.4)个月。患者术后1、3、6、12个月、末次随访时疼痛VAS评分、ODI均较术前降低,JOA评分均较术前升高,且差异均有统计学意义(P均<0.001)。结论:椎间孔镜技术是治疗80岁以上腰椎管狭窄症患者安全、有效的方法之一。

Background:It is very important to select a treatment method cautiously in patients with lumbar spinal stenosis over 80 years because of the complexity and particularity of their diseases and various comorbidities.Objective:To evaluate the efficacy of transforaminal endoscopic spine system(TESS)in the treatment of elderly patients with lumbar spinal stenosis over80 years old.Methods:From November 2012 to December 2017,52 elderly patients with lumbar spinal stenosis were treated by TESS and enrolled in this retrospective study.The VAS,ODI and JOA scores were recorded before operation,1 month,3 months,6 months and 12 months after operation.Results:Of the 52 patients,51 were followed up for(36.0±0.4)months on average(range,24-60 months).The VAS score and ODI at 1,3,6 and 12 months after operation and at the last follow-up were lower than those before operation,while the JOA score was higher than that before operation(all P<0.001).Conclusions:TESS is one of safe and effective methods for the treatment of lumbar spinal stenosis in the elderly over 80 years old.