两种术式治疗双节段退变性腰椎管狭窄症的疗效比较

Comparison of the clinical efficacy of 2 surgical methods in the treatment of double segment of degenerative lumbar spinal stenosis

目的比较显微内窥镜手术与传统开放手术治疗双节段退变性腰椎管狭窄症的临床疗效。方法 2006-03-2012-06对186例双节段退变性腰椎管狭窄患者分别采用显微内窥镜开窗减压手术和传统开放减压融合内固定手术治疗,其中内窥镜减压组95例,开放减压融合内固定手术组91例,对两组病例手术时间、术中出血量、切口长度、术后并发症、末次随访时Oswestry功能障碍指数(Oswestry disability index ODI)及优良率进行比较。结果内窥镜组手术时间、术中出血量及切口长度均较开放组少(P<0.05),术后并发症少,两组术后ODI及优良率无显著性差异(P>0.05)。结论显微内窥镜下椎管减压术治疗双节段退变性腰椎管狭窄症较开放手术创伤小、术中出血少、并发症少,并取得与开放手术相似的临床疗效。

Objective To compare the clinical efficacy of microendoscopical surgery and tradi-tional open surgery in the treatment of double segment of degenerative lumbar spinal stenosis. Methods From March 2006 to June 2012,186 patients with double segment of degenerative lumbar spinal stenosis received microendoscopical decompression by fenestration and traditional open surgical decompression and fusion with internal fixation,respectively, including endoscopic decompression group of 95 cases,open surgery decompression and internal fixation group of 91 cases. The operation time,blood loss,incision length,postoperative complications,Oswestry disabili-ty index（ODI） and excellent rate at final follow-up were compared between the two groups. Re-sults The operation time,blood loss, incision length and postoperative complications in the endo-scopic group were less than those in the open surgery group （P〈0.05）. ODI and excellent rate at final follow-up had no significant differences between the two groups （P〉0.05）. Conclusion Mi-croendoscopical decompression treatment for double segment of lumbar spinal stenosis has less trauma,less bleeding,fewer complications,and its clinical outcome is similar with open surgery.