经皮椎间孔镜手术与传统开放减压手术对老年性椎管狭窄症患者预后的影响

Effects of percutaneous transforaminal endoscopic surgery and traditional open decompression surgery on the prognosis of patients with senile lumbar spinal stenosis

目的研究经皮椎间孔镜手术与传统开放减压手术对老年性腰椎管狭窄症(LSS)患者预后的影响。方法回顾性分析我院收治的86例老年性LSS症患者的临床资料,根据手术方法将患者分为观察组(采用经皮椎间孔镜手术,n=51)与对照组(采用传统开放减压手术,n=35)。比较两组患者的手术相关指标、腰腿VAS评分、椎管面积变化及ODI评分。结果观察组患者的手术时间及住院时间短于对照组,术中出血量及手术切口优于对照组(P<0.05)。术后12、24、48及72 h,两组的腰腿疼痛VAS评分均显著低于术前,且随着时间的推移,两组的腰腿疼痛VAS评分均不断降低(P<0.05);术后12、24、48及72 h,观察组的腰腿疼痛VAS评分均低于对照组(P<0.05)。术后6、12个月,两组椎管面积均显著大于术前,且观察组大于对照组(P<0.05);两组术后12个月的椎管面积均显著大于术后6个月(P<0.05)。术后6、12个月,两组ODI评分均显著低于术前,且观察组低于对照组(P<0.05);两组术后12个月的ODI评分均显著低于术后6个月(P<0.05)。结论经皮椎间孔镜下减压术可有效优化手术相关指标,安全性高,可在短期内缓解腰腿疼痛,改善腰椎狭隘,帮助患者尽早恢复正常生活能力。

Objective To study the effects of percutaneous transforaminal endoscopic surgery and traditional open decompression surgery on the prognosis of patients with senile lumbar spinal stenosis（LSS）. Methods The clinical data of86 cases of elderly LSS patients admitted in our hospital were retrospectively analyzed. According to the surgical methods,the patients were divided into observation group（treated with percutaneous transforaminal endoscopic surgery, n=51） and control group（treated with traditional open decompression surgery, n =35）. The operation-related indexes, waist and leg VAS scores, spinal canal area changes and ODI scores were compared between the two groups. Results The operation time and hospital stay in the observation group were shorter than those in the control group, and the intraoperative blood loss and surgical incision were better than those in the control group（P〈0.05）. At 12, 24, 48 and 72 h after surgery, the waist and leg VAS scores in both groups were significantly lower than those before surgery, with the passage of time, the VAS scores of the waist and leg in both groups decreased continuously（P〈0.05）. At 12, 24, 48 and 72 h after surgery, the waist and leg VAS scores in the observation group were lower than those in the control group（P〈0.05）. At 6 and 12 months after operation, the spinal canal areas of both groups were significantly greater than those before surgery, and those of the observation group were larger than the control group（P〈0.05）. The spinal canal areas at 12 months postoperatively in the two groups were significantly greater than those at 6 months postoperatively（P〈0.05）. At 6 and 12 months after surgery, the ODI scores of both groups were significantly lower than those before surgery, and those of the observation group were lower than the control group（P〈0.05）. The ODI scores at 12 months after surgery in both groups were significantly lower than those at 6 months postoperatively（P〈0.05）. Conclusion Percutaneous transforaminal endoscopic surgery can effectively optimize the operation-related indicators, and it has high safety and short-term relief of waist and leg pain, and it can improve LSS and help patients recover the normal life momentum as soon as possible.