经皮椎间孔镜手术对腰椎管狭窄症患者术后疼痛及腰椎功能的影响

Effect of Percutaneous Foraminal Transforaminal Endoscopic Spine System on Postoperative Pain and Lumbar Function in Patients with Lumbar Spinal Stenosis

目的探讨经皮椎间孔镜(TESSYS)手术在腰椎管狭窄症患者中的应用效果。方法选取2019年1月—2022年8月我院收治的60例腰椎管狭窄症患者为研究对象,按随机数字表法分为两组,每组30例。对照组行腰椎后路椎体间融合术(PLIF),观察组行TESSYS手术,均随访3个月。比较两组患者的手术情况、术后疼痛情况、腰椎功能、Oswestry功能障碍指数(ODI)、生活质量及并发症发生情况。结果观察组的手术时间、住院时间分别为(60.58±6.12)min、(5.42±1.05)d,均短于对照组,术中出血量为(39.85±4.16)mL,少于对照组,组间差异有统计学意义(P<0.05)。观察组术后1 d、术后1周、术后3个月的疼痛视觉模拟评分分别为(3.85±0.42)分、(1.89±0.25)分、(1.25±0.23)分,均低于对照组,组间差异有统计学意义(P<0.05)。观察组术后3个月的日本骨科协会腰椎功能评分为(23.14±2.05)分,高于对照组,ODI评分为(13.25±2.01)分,低于对照组,组间差异有统计学意义(P<0.05)。观察组术后3个月的世界卫生组织生活简易量表中生理、心理、社会及环境领域评分分别为(87.43±6.15)分、(89.52±6.12)分、(90.32±4.25)分、(92.65±3.29)分,均高于对照组,组间差异有统计学意义(P<0.05)。两组的并发症发生率比较,差异无统计学意义(P>0.05)。结论采用TESSYS手术治疗腰椎管狭窄症的效果更佳,可加快患者腰椎功能恢复,降低术后VAS评分,改善其生活质量,安全可靠。

Objective To investigate the effect of percutaneous foraminal transforaminal endoscopic spine system(TESSYS)in patients with lumbar spinal stenosis.Methods 60 patients with lumbar spinal stenosis admitted to the hospital from January 2019 to August 2022 were selected as the research objects and were divided into two groups according to random number table method,with 30 cases in each group.The control group underwent posterior lumbar interbody fusion(PLIF),while the observation group underwent percutaneous foraminal TESSYS surgery.Both groups were followed up for 3 months.The surgical status,postoperative pain,lumbar function,Oswestry disability index(ODI),quality of life and complications were compared between the two groups.Results The operation time and hospital stay in the observation group were(60.58±6.12)min and(5.42±1.05)d,respectively,which were shorter than those in the control group,and the intraoperative blood loss was(39.85±4.16)mL,which was lower than that in the control group,the differences between the groups were statistically significant(P<0.05).At 1 day,1 week and 3 months after surgery,the pain visual analogue scale scores of the observation group were(3.85±0.42)points,(1.89±0.25)points and(1.25±0.23)points respectively,which were lower than those of the control group,and the differences between the groups were statistically significant(P<0.05).At 3 months after surgery,the Japanese Orthopaedic Association lumbar function score of the observation group was(23.14±2.05)points,higher than that of the control group,and the ODI score was(13.25±2.01)points,lower than that of the control group,and the differences between the groups were statistically significant(P<0.05).At 3 months after surgery,the World Health Organization quality of life-BREF scale scores such as physical,psychological,social and environmental of the observation group were(87.43±6.15)points,(89.52±6.12)points,(90.32±4.25)points and(92.65±3.29)points,respectively,which were higher than those of the control group,the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Percutaneous foraminal TESSYS surgery is safe and reliable in the treatment of lumbar spinal stenosis,which can accelerate the recovery of lumbar function,reduce the postoperative VAS score and improve the quality of life of patients.