微创椎间孔镜治疗退行性腰椎管狭窄早期临床效果

The early clinical curative effect of percutaneous transforaminal approach spinal endoscopy for treatment of degenerative lumbar spinal stenosis in elderly patients

目的:探讨微创椎间孔镜治疗老年退行性单节段腰椎管狭窄症患者早期临床疗效。方法:分析2013年1月至2014年1月温岭市第一人民医院骨科收治的80例老年退行性单节段腰椎管狭窄症患者,按照随机数字表均分为2组:研究组使用微创椎间孔镜下椎间盘髓核摘除术+椎管扩大成形术+神经根松解,对照组采用开放椎板切除减压术+椎管扩大成形术+椎间盘髓核摘除术+椎间植骨融合内固定术。比较2组患者MacNab疗效、Oswestry功能障碍指数问卷表(ODI)、视觉模拟评分(VAS)、Lehmann腰椎功能评分、JOA评估治疗分数、住院时间、术中出血量、手术并发症情况等。结果:研究组在Mac Nab疗效、ODI、VAS评分、JOA评估治疗分数、住院时间、术中出血量、手术并发症发生改善等情况方面优于对照组,差异有统计学意义(P<0.05)。结论:微创椎间孔镜治疗老年退行性单节段腰椎管狭窄症患者具有创伤小、可早期进行功能锻炼的优点,能达到良好疗效。

Objective:To evaluate the early clinical efficacy of minimal invasive transforaminal endoscopic spine system for treatment of single segment degenerative lumbar spinal in elderly patients.Methods:From January2013to January2014,eighty single segment degenerative lumbar spinal elderly patients were randomly divided into two groups according to the random number table(n=40).The research group was undergone percutaneous transforaminal endoscopic discectomy and spine canal enlarged as well as relaxing the nerve.The control group were treated by opening lamina resection decompression as well as spine canal enlarged,interbody fusion and internal fixation.The Mac Nab's criteria,ODI score,visual analogue scale(VAS),Lehmann low-back rating scale,the Japanese Orthopaedic Association Scores(JOA),the hospital stay time,the intraoperatve blood loss,the surgical complications in the two groups were reviewed and compared between the preoperative and postoperative.Results:The research group was superior than the control group in the Mac Nab's criteria,ODI score,VAS score,JOA score,the hospital stay time,the intraoperative blood loss,the surgical complications.Their differences were significant(P<0.05).Conclusion:The minimal invasive transforaminal endoscopic spine system for treatment of single segment degenerative lumbar spinal in elderly patients has the advantages of small trauma,earlier rehabilitation and good effects.