38例高龄LSS患者采用椎间孔镜选择性减压术治疗的效果探析

Effects of TESSYS selective decompression on 38 elderly LSS patients

目的探讨38例高龄腰椎管狭窄症患者采用经皮椎间孔镜选择性椎管减压术治疗的效果探析。方法选取我院骨科2017年1～5月期间38例高龄LSS患者,均行TESSYS选择性椎管减压术,观察所有患者手术情况,比较所有患者术前及术后6个月的自我腰部及下肢疼痛感受和脊椎功能改善情况,评估术后3个月临床疗效。结果手术情况:38例患者选择左、右侧入路分别为17例、21例;椎间隙为L3-4、L4-5及L5-S1分别为9例、23例及6例,手术时间95～126min,平均(86.89±8.61)min,均未进行术中输血,仅2例存在神经根瞬间异常,均未发生其他并发症,平均住院时间为(3.42±0.59)d,出院时患者背部及下肢疼痛症状均有所改善;脊髓功能改善情况:8例患者术后6个月VAS评分及ODI指数较术前明显偏低,差异有统计学意义(P<0.05),L3-4、L4-5及L5-S1椎管面积较术前均有所增加(P<0.05),38例患者术后3个月的临床疗效优良率为92.11%。结论高龄LSS患者行TESSYS选择性椎管减压术疗效显著。

Objective To explore the effects of TESSYS selective decompression on 38 elderly patients with lumbar spinal stenosis（LSS）. Methods From January 2017 to May 2017,38 elderly LSS patients treated in department of orthopedics of our hospital were selected and were treated with the TESSYS selective spinal decompression.The operation conditions of all patients were observed,and the pain of their waist and lower extremity and the improvement of spine function were compared before operation and at 6 months after operation, and the clinical efficacy at 3 months after operation was evaluated. Results Operation situation：The left approach and right approach were 17 cases and 21 cases among 38 patients.The cases of intervertebral spaces at L（3-4）,L（4-5） and L5-S1 were 9,23 and 6 cases respectively,and the operative time was 95-126（86.89±8.61）min,and there was no intraoperative transfusion,and there were only 2 cases with transient nerve root abnormalities and there was no other complications,and the mean hospital stay was（3.42±0.59）d,and the symptoms of back and leg pain were improved at discharge.Improvement of spinal cord function：The VAS score and ODI index of 8 patients at 6 months after operation were significantly lower than those before operation（P 0.05）,while the spinal canal areas at L（3-4）,L（4-5） and L5-S1 were higher than those before operation（P 0.05）.The excellent and good rate of clinical efficacy at 3 months after operation was 92.11% among the 38 patients. Conclusion TESSYS selective spinal decompression for elderly LSS patients can have significant efficacy.