Endo-ULBD技术治疗腰椎管狭窄症的临床观察

Clinical Efficacy of Endoscopic-unilateral Laminectomy for Bbilateral Decompression for Lumbar Spinal Stenosis

目的探讨脊柱内镜下腰椎后路单侧入路双侧减压(endoscopy-unilateral laminectomy for bilateral decompression,Endo-ULBD)技术治疗腰椎管狭窄症的可行性、有效性。方法回顾性分析自2018年6月至2019年6月采用Endo-ULBD技术治疗的24例腰椎管狭窄症患者资料,其中男14例,女10例;年龄42~78岁,平均(58.5±10.8)岁。责任间隙:L3~4节段8例,L4~5节段12例,L5S1节段4例。比较术前及术后1 d、术后1个月、术后6个月的视觉模拟评分(visual analogue scale,VAS)及Oswestry功能障碍指数(oswestry disability index,ODI)。末次随访时采用改良MacNab评分标准评定疗效。结果本组24例手术顺利完成,手术时间75~155min,平均(58±23)min,术后随访7~18个月,平均(11.3±2.7)个月。术后随访,VAS评分及ODI指数均较术前明显改善(P<0.05),末次随访时按照改良MacNab标准评定,优13例,良8例,可2例,差1例,优良率为87.5%。结论后路Endo-ULBD技术治疗腰椎管狭窄症安全有效,远期疗效有待进一步随访。

Objective To investigate the feasibility and efficacy of endoscopic-unilateral laminectomy for bilateral decompression(Endo-ULBD)for the treatment of lumbar spinal stenosis.Methods From Jun 2018 to Jun 2019,24 patients(male 14,female 10)underwent Endo-ULBD were retrospectively analyzed.The age ranges from 42 to 78,with an average age of(58.5±10.8).Visual analogue scale and Oswestry disability index before operation were compared with those 1 day,1 month,6 month after operation.Modified MacNab criterion evaluated at the last follow-up postoperatively was used to identify the clinical efficacy.Results All the 24 patients were followed up.The operation time ranged from 75 to 155 min,with an average of(58±23)min.VAS score and ODI score postoperatively were significantly improved compared with preoperative ones(P<0.05).Modified MacNab criterion evaluated postoperatively indicated an efficacy of 13 excellent cases,8 good,2 fair and 1 poor.Conclusion Endo-ULBD is a safe and efficient technique for the treatment of lumbar spinal stenosis.