经皮全脊柱内镜技术治疗青少年腰椎椎体后缘离断症

发布时间：2018-07-07 07:42

本文选题：腰椎 + 椎体后缘离断　；参考：《中国矫形外科杂志》2017年19期

【摘要】：[目的]探讨经皮全脊柱内镜技术治疗青少年腰椎椎体后缘离断症的疗效。[方法]2012年9月~2015年9月采用经皮全脊柱内镜技术治疗腰椎椎体后缘离断症患者28例,男17例,女11例;年龄16~25岁,平均18.80岁。责任节段L_(2/3)1例、L_(3/4)6例、L_(4/5)15例、L_5/S_1 6例。25例采用经椎间孔入路,3例采用经椎板间入路。[结果]手术时间60~170 min,平均90 min。1例经椎板间隙入路手术术中发生硬脊膜撕裂而中转开放手术,所有病例均未出现神经根及马尾损伤并发症。1例术后第5 d出现手术节段椎间盘突出,采用显微内窥镜下椎间盘摘除术翻修;其余26例患者随访12~36个月,平均18.80个月。末次随访时VAS评分由术前的(5.81±2.73)分下降至(1.63±1.12)分(P0.05),腿痛VAS评分由术前的(5.74±2.30)分下降至(0.81±0.55)分(P0.05),ODI由术前的(52.55±19.22)%降至(11.88±7.60)%(P0.05)。Mac Nab法疗效评定结果优18例、良7例、可1例。[结论]经皮全脊柱内镜技术治疗青少年腰椎椎体后缘离断症能保留腰椎活动度、明显缓解症状,术后近期疗效良好。术后12个月腰椎MRI显示手术节段椎体后缘获得良好塑型。
[Abstract]:Objective: to evaluate the effect of percutaneous total spinal endoscopy in the treatment of lumbar posterior edge amputation in adolescents. [methods] from September 2012 to September 2015, 28 patients (17 males and 11 females) were treated with percutaneous total spinal endoscopy (age: 1625 years, mean 18.80 years). Responsibility segment L2 / 3 1 case L3 / 4 6 cases L4 / 5 15 cases L5 / S16 cases. 25 cases adopted intervertebral foramen approach 3 cases translaminar approach. [results] the operative time was 60 ~ 170 minutes. The average time of operation was 90 min.1. The dural tear occurred during the operation through the interlaminar space approach and was converted to open surgery. There were no complications of nerve root and cauda equina injury in all cases. The operative segment disc herniation occurred in 1 cases on the 5th day after operation, and the other 26 cases were followed up for 12 ~ 36 months (mean 18.80 months) by microendoscopic discectomy and revision. At the last follow-up, the scores of VAS decreased from (5.81 卤2.73) to (1.63 卤1.12) (P0.05), the scores of leg pain decreased from (5.74 卤2.30) to (0.81 卤0.55) (P0.05) ODI decreased from (52.55 卤19.22)% to (11.88 卤7.60)% (P0.05). [conclusion] Percutaneous total spinal endoscopy can preserve lumbar mobility and relieve symptoms. 12 months after operation, MRI showed that the posterior edge of the segmental vertebrae was well shaped.
【作者单位】：南华大学附属第一医院脊柱外科;
【分类号】：R726.8

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