经皮椎间孔镜治疗腰椎管狭窄症的临床效果

Clinical effect of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar spinal stenosis

目的探讨经皮椎间孔镜治疗腰椎管狭窄症(LSS)的临床效果。方法回顾性分析43例单节段LSS患者的临床资料,根据不同术式将患者分为A组(经皮椎间孔镜,22例)与B组[后路腰椎体间融合术(PLIF),21例]。比较两组的治疗效果。结果A组患者的切口长度、住院时间均短于B组,手术时间长于B组,透视次数多于B组,出血量少于B组(P<0.05)。术前、术后6个月、1年及末次随访时,两组的VAS、ODI评分比较,差异无统计学意义(P>0.05);术后1个月,A组的VAS、ODI评分低于B组(P<0.05)。结论经皮椎间孔镜治疗LSS的临床效果显著,且具有手术创伤小、出血少、康复快的特点,值得临床推广应用。

Objective To investigate the clinical effect of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar spinal stenosis(LSS).Methods The clinical data of 43 patients with single segment LSS were analyzed retrospectively,and the patients were divided into group A(percutaneous transforaminal endoscopic discectomy,22 cases)and group B[posterior lumbar interbody fusion(PLIF),21 cases]according to the different operative methods.The therapeutic effects of the two groups were compared.Results The incision length and hospitalization time in the group A were shorter than those in the group B,the operation time was longer than that in the group B,the times of fluoroscopy was more than that in the group B,and the amount of bleeding was less than that in the group B(P<0.05).Before operation,at 6 months,1 year after operation and the last follow-up,there were no significant differences in the scores of VAS and ODI between the two groups(P>0.05);at 1 month after operation,the scores of VAS and ODI in the group A were lower than those in the group B(P<0.05).Conclusion The percutaneous transforaminal endoscopic discectomy in the treatment of LSS has significant clinical effect,and it has the characteristics of less surgical trauma,less bleeding and fast recovery,which is worthy of clinical promotion and application.