经皮椎间孔脊柱内镜技术结合康复训练促进退变性腰椎管狭窄症患者康复效果观察

Observation on rehabilitation effect of percutaneous foraminal spinal endoscopy combined with rehabilitation training in patients with degenerative lumbar spinal stenosis

目的:分析经皮椎间孔脊柱内镜技术与康复训练结合方案促进退变性腰椎管狭窄症患者康复的效果。方法:选取本院收治66例退变性腰椎管狭窄症患者作为研究对象。采取随机数字表法将患者分为对照组和试验组,各组33例。对照组采取椎管减压并椎体间或者后外侧融合术结合康复训练治疗;试验组采取经皮椎间孔脊柱内镜技术结合康复训练治疗,治疗后比较各组患者治疗效果、患者手术时间与术中出血量、住院时间、患者满意度情况等,采用视觉模拟疼痛评分法(Visual analogue scale,VAS)对比术后2 w、术后4 w、术后8 w患者疼痛评分情况,采用日本骨科协会评估治疗分数(Japanese Orthopedic Association scores,JOA)对比术前及术后4 w、术后8 w患者情况。结果:试验组治疗效果显著优于对照组(P<0.05)。试验组术后2 w、术后4 w、术后8 w的VAS评分均显著低于对照组(P<0.05)。与对照组比较,试验组的手术时间以及住院时间均显著缩短,术中出血量显著减少(P<0.05)。术前两组的JOA评分比较均无显著差异(P>0.05).术后4 w与术后8 w试验组的JOA评分均比对照组显著提高(P<0.05)。试验组的手术治疗满意率比对照组显著提高(P<0.05)。结论:对退变性腰椎管狭窄症患者采取经皮椎间孔脊柱内镜技术与康复训练结合治疗,能缓解疼痛,改善手术情况,促进腰椎功能恢复,提高治疗满意度。

Objective:To analyze the effect of percutaneous foraminal spinal endoscopy combined with rehabilitation training program in promoting rehabilitation of patients with degenerative lumbar spinal stenosis.Methods:Sixty-six patients with degenerative lumbar spinal stenosis were selected as the study objects.The patients were divided into control group and experimental group by random number table method,with 33 cases in each group.The control group was treated with decompression of spinal canal and intervertebral or posterolateral fusion combined with rehabilitation training.The experimental group was treated with percutaneous foraminal spinal endoscopy combined with rehabilitation training.After treatment,the therapeutic effect,operative time,intraoperative blood loss,length of hospital stays,and patient satisfaction of all groups were compared.visual analogue pain scoring method was adopted.VAS)were used to compare patients'pain scores at 2,4 and 8 weeks after surgery.Japanese Orthopedic Association scores(JOA)were used to compare patients'pain scores before surgery,4 and 8 weeks after surgery.Results:The therapeutic effect of experimental group was significantly better than that of control group(P<0.05).VAS scores of experimental groups at 2,4 and 8 weeks after surgery were significantly lower than those of control group(P<0.05).Compared with the control group,the operation time and hospitalization time of experimental group were significantly shortened,and the amount of intraoperative blood loss was significantly reduced(P<0.05).There were no significant differences in JOA scores between the two groups before surgery(P>0.05).The JOA scores of the experimental group were significantly higher than those of the control group at 4 weeks and 8 weeks after surgery(P<0.05).The satisfaction rate of the experimental group was significantly higher than that of the control group(P<0.05).Conclusion:The combination of percutaneous foraminal spinal endoscopy and rehabilitation training for patients with degenerative lumbar spinal stenosis can relieve pain,improve the operation,promote the recovery of lumbar function and improve the satisfaction of treatment.