单侧双通道内镜下减压治疗腰椎管狭窄症的效果观察

Observation on the therapeutic effect of unilateral biportal endoscopy decompression for lumbar spinal stenosis

目的:探讨单侧双通道内镜下减压治疗腰椎管狭窄症的临床效果。方法:纳入2019年7月—2022年7月在广东省英德市人民医院就诊的54例腰椎管狭窄症患者,根据医患沟通结果,按手术方式不同分为观察组24例与对照组30例。观察组行单侧双通道内镜减压术治疗,对照组行传统开放减压术治疗。比较两组出血量、手术耗时、住院时间、并发症发生率,术前及术后1、6、12个月视觉模拟量表(VAS)评分、oswestry功能障碍指数(oDI)。结果:两组手术时间、并发症发生率比较,差异无统计学意义(P>0.05)。观察组与对照组发生腰椎手术失败综合征1例,对照组发生脑脊液漏2例。观察组住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。两组VAS评分及oDI变化情况比较,差异均有统计学意义(P<0.05)。术前,观察组VAS评分高于对照组,差异有统计学意义(P<0.05);术后1个月时,两组VAS评分比较,差异无统计学意义(P>0.05);术后6、12个月,观察组VAS评分均低于对照组,差异均有统计学意义(P<0.05)。术前,两组oDI比较,差异无统计学意义(P>0.05);术后1、6、12个月,观察组oDI均低于对照组,差异均有统计学意义(P<0.05)。结论:单侧双通道内镜下减压治疗腰椎管狭窄症,有出血少、疗效好、术后恢复快等优点。

Objective Clinical efficacy of unilateral double-channel endoscopic decompression in the treatment of lumbar spinal stenosis.Methods A total of 54 patients with lumbar spinal stenosis who were treated in Yingde City People's Hospital from July 2019 to July 2022 were included.According to the results of doctor-patient communication,they were divided into observation group(24 cases)and control group(30 cases)according to different surgical methods.The observation group underwent unilateral double-channel endoscopic decompression,while the control group underwent traditional open decompression surgery.The intraoperative blood loss,operation time,length of hospital stay,and incidence of complications were compared between the two groups.The visual analog scale(VAS)scores for pain and the Oswestry Disability Index(ODI)of the lumbar spine were evaluated before surgery and at 1,6,and 12 months after surgery.Results There was no statistically significant difference in operation time and incidence of complications between the two groups(P>0.05).One case of lumbar surgery failure syndrome occurred in both the observation group and the control group,and two cases of cerebrospinal fluid leakage occurred in the control group.The length of hospital stay and intraoperative blood loss in the observation group were shorter and less,respectively,than those in the control group,and the differences were statistically significant(P<0.05).The changes in VAS scores and ODI between the two groups were statistically significant(P<0.05).Before surgery,the VAS score in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).At 1 month after surgery,there was no statistically significant difference in VAS scores between the two groups(P>0.05).At 6 and 12 months after surgery,the VAS scores in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before surgery,there was no statistically significant difference in ODI between the two groups(P>0.05).At 1,6,and 12 months after surgery,the ODI in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion:Unilateral double-channel endoscopic decompression for the treatment of lumbar spinal stenosis has the advantages of less bleeding,good curative effect and rapid postoperative recovery.