经皮内窥镜下经椎间孔入路腰椎椎间融合术治疗退行性腰椎椎管狭窄症的效果观察

Observation of therapeutic effect of percutaneous transforaminal endoscopic lumbar interbody fusion on degenerative lumbar spinal stenosis

目的分析经皮内窥镜下经椎间孔入路腰椎椎间融合术(TLIF)治疗退行性腰椎椎管狭窄症(DLSS)的效果。方法队列研究。抽取2022年1月至2023年12月延安大学附属医院收治的108例DLSS患者,按随机数字表法分为对照组与观察组,每组54例。对照组行传统开放TLIF,观察组行经皮内窥镜下TLIF。比较两组围术期指标(术中出血量、手术时间、住院时间)及并发症发生情况。比较两组手术前后腰部疼痛程度[视觉模拟评分法(VAS)评分]、腰椎功能[Oswestry功能障碍指数(ODI)]。结果观察组术中出血量少于对照组,手术时间、住院时间短于对照组(P<0.05)。术后,观察组腰部VAS评分[(1.71±0.42)分]及ODI[(14.71±1.69)分]低于对照组[(2.53±0.53)分、(18.35±2.01)分],差异有统计学意义(P<0.05)。观察组并发症发生率(3.70%,2/54)低于对照组(16.67%,8/54),差异有统计学意义(P<0.05)。结论经皮内窥镜下TLIF具有创伤小、并发症少等优点,可以减轻DLSS患者腰痛,改善腰椎功能。

ObjectiveTo analyze the effect of percutaneous transforaminal endoscopic lumbar interbody fusion(TLIF)on degenerative lumbar spinal stenosis(DLSS).MethodsA total of 108 DLSS patients admitted to Yan’an University Affiliated Hospital from January 2022 to December 2023 were selected for the cohort study.And they were divided into a control group and an observation group by random number table method,with 54 cases in each group.The control group received traditional open TLIF,while the observation group received percutaneous endoscopic TLIF.The perioperative indicators(intraoperative blood loss,operation time,hospital stay)and incidence of complications were compared between the two groups.The preoperative and postoperative degree of waist pain evaluated by visual analogue scale(VAS)score and lumbar function assessed by Oswestry disability index(ODI)were compared between the two groups.ResultsThe observation group had less intraoperative blood loss,shorter operation time and shorter hospital stay compared with the control group(P<0.05).After operation,the VAS score of waist(1.71±0.42)and ODI(14.71±1.69)in the observation group were lower than those in the control group(2.53±0.53,18.35±2.01),P<0.05.The incidence of complications in the observation group(3.70%,2/54)was lower than that in the control group(16.67%,8/54),and the difference was significant(P<0.05).ConclusionsPercutaneous endoscopic TLIF has the advantages of less trauma and fewer complications,which can alleviate waist pain and improve lumbar function.