椎间孔镜下椎间孔扩大成形术对腰椎管狭窄患者腰椎功能及并发症的影响

Effect of Foraminoscopic Foraminal Enlargement on Lumbar Function and Complications in Patients with Lumbar Spinal Stenosis

目的探究腰椎管狭窄患者采用椎间孔镜下椎间孔扩大成形术治疗的效果。方法选取临朐县人民医院2020年9月—2022年8月收治的74例腰椎管狭窄患者为研究对象,按随机数字表法分为两组,每组37例。对照组行开窗减压术,观察组行椎间孔镜下椎间孔扩大成形减压术。比较两组的围术期指标、腰椎功能及并发症发生情况。结果观察组的手术时间、住院时间均短于对照组,术中出血量少于对照组,术后24 h的疼痛视觉模拟评分低于对照组,组间差异有统计学意义(P<0.05)。术后3个月,观察组的Oswestry功能障碍指数问卷表(ODI)评分低于对照组,日本骨科协会评估表(JOA)评分高于对照组,组间差异有统计学意义(P<0.05)。观察组的并发症发生率为5.41%,低于对照组的21.62%,差异有统计学意义(P<0.05)。结论腰椎管狭窄患者行椎间孔镜下椎间孔扩大成形术治疗,可优化围术期指标,加快腰椎功能恢复,并可减少并发症,值得临床推广使用。

Objective To investigate the effect of foraminoscopic foraminal enlargement in the treatment of lumbar spinal stenosis.Methods 74 patients with lumbar spinal stenosis admitted to lingu County People’s Hospital from September 2020 to August 2022 were selected as the research objects and divided into two groups according to random number table method,with 37 cases in each group.The control group underwent fenestration decompression,and the observation group underwent foraminoscopic foraminal enlargement.The perioperative indexes,lumbar function and complications were compared between the two groups.Results The operation time and hospital stay of the observation group were shorter than those of the control group,the amount of blood loss during the operation was less than that of the control group,and the pain visual analogue scale score at 24 h after the operation was lower than that of the control group,the differences between the groups were statistically significant(P<0.05).3 months after surgery,the Oswestry disability index(ODI)score of the observation group was lower than that of the control group,and the Japanese Orthopaedic Association evaluation scale(JOA)score was higher than that of the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 5.41%,lower than 21.62%in the control group,and the difference was statistically significant(P<0.05).Conclusion Foraminoscopic foraminal enlargement can optimize perioperative indexes,accelerate the recovery of lumbar function and reduce complications,and is worthy of clinical application.