全内窥镜侧后路减压治疗腰椎间孔狭窄症

The Endoscopic Treatment of Stenosis of Lateral Posterior Decompression of Lumbar Intervertebral Foramen

目的观察全内窥镜下侧后路精准减压治疗腰椎间孔狭窄症减压效果及疗效。方法对27例腰椎间孔狭窄症患者行侧后路精准减压,术后随访,记录术前1 d、术后3月、术后6月、术后1年ODI评分、下肢痛VAS评分。结果 27例患者均在局麻下顺利完成手术。椎间孔面积由手术前的(46.89±5.89)mm^2扩大到(112.52±26.13)mm^2(P<0.01)。患者腰痛及下肢痛症状较术前明显改善,VAS下肢痛评分由术前(6.71±0.72),改善到术后3月(2.85±0.77),术后6月(2.81±0.41),术后1年(2.71±0.47)(P<0.05)。ODI评分由术前(71.11±6.08),改善到术后3月(27.26±5.18),术后6月(2.59±1.81),术后1年(12.74±1.59)(P<0.05)。结论全内窥镜下侧后路精准减压治疗腰椎间孔狭窄症可以充分减压神经根,快速缓解患者下肢疼痛症状,改善患者生活质量,是一项安全有效的脊柱微创手术技术。

Objective To describe the details of the full-endoscopic targetal lumbar foraminal decompression technique for lumbar foraminal stenosis and to demonstrate the clinical outcomes. Methods 27 patients with lumbar foraminal stenosis who underwent endoscopic forminotomy were included in this study. The clinical outcomes were assessed using the Oswestry Disability Index（ODI）, Visual Analog Scale（VAS） at preoperation, 1, 3, 6 months and 1 year post-operation. Results 27 patients endurance the operation under local anesthesia. The area of intervertebral foramen increased from（46.89 ± 5.89） mm^2 pre-operation to（112.52 ± 26.13） mm^2 post-operation（P〈0.01）. The mean VAS for leg pain improved from（6.71±0.72） pre-operation to（2.85±0.77） at 3 months,（2.81±0.41） at 6 months, and（2.71±0.47） at 12 months post-operation（P〈0.05）. The mean ODI improved from（71.11±6.08） pre-operation to（27.26±5.18） at 3 months,（12.59±1.81） at 6 months, and（12.59±1.81） at 1 year postoperation（P〈0.05）. Conclusion The full-endoscopic targetal lumbarforaminal decompression procedure may relieve clinical symptoms and increase life quality for patients with lumbar foraminal stenosis. It is a safe and efficacious minimal invasive spinal surgical technique.