椎间孔镜技术两种手术入路在治疗单节段退行性腰椎管狭窄症中的临床应用比较

Comparison between two approaches of percutaneous endoscopic lumbar discectomy in treatment of single-segment degenerative lumbar spinal stenosis

目的观察和比较椎间孔镜技术两种不同手术入路—经椎间孔入路和经椎板间入路,治疗单节段退行性腰椎管狭窄症的临床疗效和安全性。方法回顾性分析2017年4月1日-2018年4月1日徐州医科大学附属医院疼痛科因单节段退行性腰椎管狭窄症接受椎间孔镜手术的患者32例,分为经椎间孔入路(TF组)(n=20)和经椎板间入路(IL组)(n=12)两组。比较两组患者术前、术后1个月、3个月和6个月的疼痛数字评分(NRS)、改良的Oswestry功能障碍指数(ODI)、手术时间、透视次数、手术费用、术后满意度和手术并发症等。结果两组患者术后NRS和ODI均较术前明显降低(P<0.05),但两组间NRS、ODI、手术时间和满意度比较,差异均无统计学意义(P>0.05)。结论椎间孔镜技术两种手术入路均可有效治疗单节段退行性腰椎管狭窄症。

Objective To observe and compare the clinical efficacy and safety of transforminal and interlaminar approaches of percutaneous endoscopic lumbar discectomy(PELD)in treatment of single-segment degenerative lumbar spinal stenosis(DLSS).Methods A retrospective analysis was performed on 32 patients who underwent PELD for single-segment DLSS,from April 1st 2017 to April 1st 2018.Twenty cases were treated by transforminal(TF)approach and 12 patients underwent interlaminar(IL)approach.We compared the numerical rating scale(NRS)and improved Oswestry disability index(ODI)between the two groups,as well as the operation time,number of fluoroscopy,complications,costs,satisfaction,and so on.Results The postoperative NRS and ODI of patients in the two groups were lower than preoperation(P<0.05).However,there were no significant difference in NRS,ODI,operation time,complications and satisfaction between the two groups(P>0.05).Conclusion PELD can effectively treat single-segment DLSS.