椎间孔镜下保留椎间盘治疗腰椎间盘膨出并侧隐窝狭窄症的近期疗效

Short-term Observation of Intervertebral Disc Preservation for the Treatment of Bulging Lumbar Disc and Lateral Crypt Senosis

目的观察椎间孔镜下保留椎间盘治疗腰椎间盘膨出并侧隐窝狭窄症的近期临床疗效。方法回顾性分析2017年5月-2018年7月采用椎间孔镜技术治疗并获得随访的26例腰椎间盘膨出并侧隐窝狭窄症患者的临床资料,分别于术前及术后1 d,1月,3月和末次随访采用视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和改良MacNab疗效评定标准进行分析评估。结果随访时间9月(5~17月)。术前腿痛VAS评分(6.8±1.3),术后1 d,1月,3月及末次随访VAS评分分别为(2.1±0.9),(1.9±1.0),(1.8±0.7)及(1.4±0.5);术前ODI指数(53.50±14.50),术后1 d,1月,3月及末次随访ODI指数分别为(21.00±13.50),(16.50±10.50),(12.50±8.00)及(10.50±7.50)。术前与术后1 d,1月,3月及末次随访比较,VAS评分及ODI指数差别均有统计学意义(P<0.05);改良MacNab疗效评定,优11例,良12例,可2例,差1例,优良率88.5%。结论椎间孔镜下保留椎间盘治疗腰椎间盘膨出并侧隐窝狭窄症是一种安全、有效的微创治疗方式。

Objective To observe the short-term clinical effect of foraminoscopy in the treatment of lumbar disc bulging with lateral recess stenosis by preserving the intervertebral disc.Methods The clinical data of 26 patients with lateral recess stenosis and disc bulging treated by foraminoscopy from May 2017 to July 2018 were retrospectively analyzed.Visual analogue scale(VAS),Oswestry dysfunction index(ODI)and modified MacNab efficacy evaluation criteria were used to analyze and evaluate the outcomes pre-operatively and 1 day,1 month,3 months post-operatively,and the last follow-up.Result All patients were followed up for 5 to 17 months,with an average of 9 months.The VAS score of leg pain before operation was(6.8±1.3),1 day,1 month,3 months and the last follow-up were(2.1±0.9),(1.9±1.0),(1.8±0.7),(1.4±0.5),respetively.The ODI score before operation was(53.50±14.50).The ODI score for 1 day,1 month,3 months post-operation,and the last follow-up were(21.00±13.50),(16.50±10.50),(12.50±8.00),(10.50±7.50),respectively,and the difference was statistically significant(P<0.05)The results of modified MacNab were excellent in 11 cases,good in 12 cases,fair in 2 cases,and poor in 1 case.The excellent and good rate was 88.5%.Conclusion It is a safe and effective minimally invasive method to treat lateral recess stenosis with bulging disc by preserving intervertebral disc under foramen endoscopy.