二次椎间孔成形术治疗腰椎管狭窄症的疗效观察

Efficacy of secondary intervertebral foraminoplasty in the treatment of lumbar spinal stenosis

目的观察二次椎间孔成形术治疗腰椎管狭窄症的疗效。方法应用椎间孔镜行二次椎间孔成形术治疗24例腰椎管狭窄症患者,其中L3/L4 3例,L4/L5 16例,L5/S1 5例。采用视觉模拟评分(visual analogue scales,VAS)和Oswestry功能障碍指数(ODI)的评价疗效。结果 24例均顺利完成手术,手术时间65～95 min,平均(74.6±9.3) min;出血量5～10 mL,住院时间5～8 d,平均6.0 d。术后即刻、术后1、6、12个月的VAS及ODI评分均比术前降低,差异有统计学意义(P<0.01)。结论经皮椎间孔镜二次椎间孔成形术治疗腰椎管狭窄症具有切口小、损伤小、出血少、术后恢复快、住院时间短等优点,二次椎间孔成形术是一种治疗腰椎管狭窄症有效、微创、安全的手术方法。

Objective To study the clinical effect of secondary intervertebral foraminoplasty in the treatment of lumbar spinal stenosis.Methods 24 patients with lumbar spinal stenosis were treated with secondary intervertebral foraminoplasty were included in the study,including 3 cases of L3/L4,16 cases of L4/L5 and 5 cases of L5/S1.The short-term outcomes of all patients were evaluated using the visual analogue scales (VAS) scores and Oswestry disability index (ODI).Results The operation was successfully completed on 24 patients.The operation time was 65-95 min with an average of (74.6±9.3) min;the bleeding volume was 5-10 mL;and the hospital stay was 5-8 days with an average of 6.0 d.Compared with those before the operation,the VAS and ODI scores at immediately after the operation,postoperative 1 month,6 months and 12 months were significantly reduced,and the difference was statistically significant (P<0.01).Conclusion The treatment of lumbar spinal stenosis with secondary intervertebral foraminoplasty has the advantages of small incision,less injury,less bleeding, rapid recovery and short hospital stay.The secondary intervertebral foraminoplasty is an effective,minimally invasive and safe surgical method for the treatment of lumbar spinal stenosis.