全脊柱内窥镜治疗合并椎管内骨化腰椎疾患疗效观察
发布时间：2019-08-24 07:22
【摘要】：目的探讨经皮全脊柱内窥镜技术治疗合并椎管内骨化腰椎疾患的可行性有效性和安全性。方法 2008年7月—2016年6月采用全脊柱内窥镜技术治疗96例合并椎管内骨化的腰椎间盘突出症或腰椎管狭窄症患者。其中男59例,女37例;年龄13~57岁,平均29.5岁。病程3~51个月,平均18.2个月。51例有明确腰部外伤史。单节段单侧症状92例,双侧症状4例。骨化性质为椎体后缘离断症89例,纤维环或后纵韧带骨化7例。骨化为侧方型32例,中央型13例,混合型51例。镜下去除致压因素,如突出的髓核增生黄韧带关节囊或上关节突骨赘结构。椎间孔入路50例采用局麻或持续硬膜外麻醉,椎板间入路46例采用持续硬膜外麻醉或全麻。术前及末次随访时采用疼痛视觉模拟评分(VAS)评价下肢疼痛程度,末次随访时根据改良Macnab标准评定手术疗效。结果患者手术均顺利完成。经椎间孔入路者手术时间平均53 min,术中透视次数平均8次;经椎板间入路者分别为58 min和3次。术后卧床时间平均6.5 h,住院时间平均4.7 d。术后患者均获随访,随访时间6~18个月,中位时间11个月。术后3 d腰椎CT三维重建示,骨化组织未切除26例,部分切除12例,完全切除49例;术后3个月腰椎MRI示硬膜囊及神经根未见压迫。末次随访时下肢疼痛VAS评分为(0.7±1.1)分,较术前的(5.8±1.1)分显著降低(t=1.987,P=0.025);根据改良Macnab标准评价获优87例、良5例、可4例,优良率95.8%。结论全脊柱内窥镜治疗合并椎管内骨化腰椎疾患有效、安全、微创,近期疗效可靠。骨化处理方式应结合症状、影像、风险评估结果综合分析。
[Abstract]:Objective to investigate the feasibility of percutaneous total spinal endoscopy in the treatment of lumbar spondylosis complicated with intraspinal ossification. Effectiveness and safety. Methods from July 2008 to June 2016, 96 patients with lumbar disc protrusion or lumbar spinal stenosis complicated with intraspinal ossification were treated with total spinal endoscopy. There were 59 males and 37 females with an average age of 29.5 years. The course of disease was 3 鈮，
本文编号：2528788
[Abstract]:Objective to investigate the feasibility of percutaneous total spinal endoscopy in the treatment of lumbar spondylosis complicated with intraspinal ossification. Effectiveness and safety. Methods from July 2008 to June 2016, 96 patients with lumbar disc protrusion or lumbar spinal stenosis complicated with intraspinal ossification were treated with total spinal endoscopy. There were 59 males and 37 females with an average age of 29.5 years. The course of disease was 3 鈮，
本文编号：2528788
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