单侧入路双侧减压术和全椎板切除减压术治疗腰椎管狭窄症的临床疗效

Clinical efficacy of bilateral decompression of vertebral canal via unilateral approach and laminectomy in treatment of lumbar spinal stenosis

目的探讨单侧入路双侧减压术与全椎板切除减压术治疗腰椎管狭窄症的临床疗效。方法双侧神经症状性腰椎管狭窄症患者56例随机分为单侧入路双侧减压组(A组,29例)和全椎板切除减压组(B组,27例),比较两组临床疗效。结果两组手术时间、术中出血量无统计学差异(P>0.05);B组术后引流量和肌酸激酶水平较A组增加(P<0.05)。与术前相比,两组术后VAS疼痛评分和腰椎功能障碍指数(ODI)评分均降低(P<0.05);两组术后腿痛VAS疼痛评分、ODI评分及椎间融合情况比较均无统计学差异(P>0.05),而A组腰痛VAS疼痛评分低于B组(P<0.05)。结论单侧入路双侧减压术和全椎板切除减压术治疗腰椎管狭窄症均取得较好的临床疗效,但前者具有创伤小和并发症少等优点。

Objective To investigate the clinical efficacy of bilateral decompression via unilateral aproach and laminectomy in the treatment of lumbar spinal stenosis.Methods A total of 56 patients with lumbar spinal stenosis was randomly divided into two groups of A（treated with bilateral decompression via unilateral approach,29cases）and B（treated with laminectomy,27cases）.The clinical efficacy was compared between two groups.Results The operation time and intraoperative blood loss in group A were similar to those in group B（P0.05）.The postoperative drainage and level of creatine kinase in group B were higher than those in group A（P0.05）.Compared with before,VAS pain score and Oswestry disability index（ODI）score were decreased after surgery in both groups（P0.05）.There were no statistical differences of ODI score,VAS pain score of leg and intervertebral fusion after surgery between groups of A and B（P0.05）,while VAS pain score of back in group A was lower than that in group B（P0.05）.Conclusion Both bilateral decompression via unilateral approach and laminectomy achieve good clinical efficacy in the treatment of lumbar spinal stenosis,but the former surgery has the advantages of less trauma and fewer complications.