椎间孔镜下椎板间入路选择性减压治疗对退行性腰椎管狭窄患者围手术指标、Oswestry功能障碍指数及并发症的影响

The effect of selective decompression through the interlaminar approach of the vertebral plate under theintervertebral foraminoscope on the perioperative indexes,Oswestry dysfunction index and complications of patients with degenerative lumbar spinal stenosis

目的分析椎间孔镜下椎板间入路选择性减压治疗对退行性腰椎管狭窄患者围手术指标、Oswestry功能障碍指数及并发症的影响。方法选取2017年5月至2020年5月我院手术治疗的92例退行性腰椎管狭窄者,根据手术方法不同分为对照组(全椎板切除术治疗)及观察组(椎间孔镜下椎板间入路选择性减压治疗)各46例。比较两组临床疗效、围手术指标、Oswestry功能障碍指数、疼痛情况、生活质量及并发症。结果观察组总有效率高于对照组,各项围手术指征优于对照组(P<0.05);术后3、6个月观察组VAS评分、ODI指数均较术前降低,且低于对照组(P<0.05);术后观察组SF-36各项评分均高于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05)。结论退行性腰椎管狭窄者以椎间孔镜下椎板间入路选择性减压可有效改善功能情况及手术指征,降低疼痛,且术后并发症低。

Objective To analyze the effect of selective decompression through the interlaminar approach of the vertebral plate under the intervertebral foraminoscope on the perioperative indexes,Oswestry dysfunction index and complications of patients with degenerative lumbar spinal stenosis.Methods Ninety-two patients with degenerative lumbar spinal stenosis treated with surgery in our hospital from May 2017 to May 2020 were selected.According to different surgical methods,they were divided into control group(total laminectomy treatment)and observation group(selective decompression),46 in each group.The clinical efficacy,perioperative indicators,Oswestry dysfunction index,pain status,quality of life and complications were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The perioperative indexes of the observation group were significantly better than those of the control group(P<0.05).After 3 and 6 months of operation,Visual analogy score(VAS)and Oswestry disability index(ODI)of patients in the observation group were lower than those before operation,and significantly lower than those of the control group(P<0.05).The scores of 36-item Short Form Health Survey Questionnaire(SF-36)in the observation group were higher than those in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The selective decompression can effectively improve the functional status and surgical indexes,and reduce the pain in patients with degenerative lumbar spinal stenosis.The incidence of postoperative complications is also low.