经皮椎间孔镜TESSYS-ISEE技术治疗老年腰椎侧隐窝狭窄症

Percutaneous endoscopic lumbar decompression with TESSYS-ISEE technique for lumbar lateral recess stenosis in elderly

[目的]探讨经皮椎间孔镜TESSYS-ISEE技术治疗老年腰椎侧隐窝狭窄症的安全性及有效性。[方法]回顾性分析了本院2017年1月~2018年5月采用经皮椎间孔镜TESSYS-ISEE技术治疗并获得随访的29例老年腰椎侧隐窝狭窄症患者的临床资料,采用VAS评分和ODI评分评价临床疗效。末次随访时,采用改良MacNab标准评定优良率。[结果]所有患者均顺利完成手术,1例术中发生硬膜撕裂,无神经血管损伤、椎间隙感染、症状性髓核残留等并发症发生。手术时间55~95 min,平均(72.29±11.52)min;术后住院时间2~6 d,平均(3.75±1.04)d;29例患者获得13~25个月随访,平均(18.76±3.92)个月。随访期间,1例患者腰椎间盘突出复发。术后各时间点腰痛VAS评分、腿痛VAS评分及ODI评分均较术前改善(P<0.05)。末次随访时,根据改良MacNab评分标准评定优良率为89.66%。[结论]经皮椎间孔镜TESSYS-ISEE技术能安全、有效地治疗老年腰椎侧隐窝狭窄症,可在临床推广应用。

[Objective]To explore the safety and efficiency of TESSYS-ISEE technique used in percutaneous endoscopic lumbar decompression for lumbar lateral recess stenosis in elderly.[Methods]A retrospective study was conducted on 29 elderly patients who underwent percutaneous endoscopic lumbar decompression with TESSYS-ISEE technique for lumbar lateral recess stenosis from January 2017 to May 2018 in our institution.The clinical consequences were evaluated with visual analogue scale(VAS)score for pain and Oswestry disability index(ODI)and the modified MacNab’s criteria.[Results]All patients received successful surgical procedures with operation time of(72.29±11.52)mins,postoperative hospital stay of(3.75±1.04)days.Except dural tear in 1 case,no serious complications,such as neurovascular injury,intervertebral infection and symptomatic residual disc herniations were found in anyone of them.All the 29 patients were followed up for 13~25 months with a mean of(18.76±3.92)months.During follow-up period,only 1 patient experienced the recurrent lumbar disc herniation.The postoperative VAS scores of low back pain and leg pain,as well as ODI scores significantly improved at the latest follow up compared with those before operation(P<0.05).Base on the modified MacNab’s criteria,the excellent and good rate of the clinical outcomes was 89.66%at the latest follow-up.[Conclusion]The TESSYS-ISEE technique used in percutaneous endoscopic lumbar decompression is safe and effective treatment for lumbar lateral recess stenosis in elderly.