椎间孔镜技术治疗腰椎融合后临近节段病变的临床疗效
发布时间：2018-07-27 20:56
【摘要】：[目的]探讨经皮椎间孔镜技术治疗腰椎融合术后相邻节段退变的临床疗效。[方法]回顾性分析2010年8月~2015年8月于本院应用经皮椎间孔镜治疗并获得随访的23例腰椎融合术后相邻节段退变患者的临床资料,采用视觉模拟评分法(visual analogue scale/score,VAS)评估手术疗效,应用日本骨科协会(Japanese Orthopaedic Association Scores,JOA)评分对腰椎功能进行评估,并计算JOA改善率,术后1年改良Mac Nab标准评估临床疗效。[结果]手术时间40~85 min,平均55 min;出血量5~25 ml,平均10 ml;住院时间3~14 d,平均7 d。所有患者随访6~24个月,平均13.5个月。术前VAS评分为(7.13±0.54)分,术后3 d为(2.05±0.34)分,末次随访为(1.41±0.28)分。术前与术后3 d、末次随访比较差异有统计学意义(P0.01);术前JOA评分为(9.89±0.53)分,出院当天评分为(18.23±2.25)分,末次随访评分为(28.41±2.34)分,术前与出院时、末次随访比较差异有统计学意义(P0.01)。根据JOA评分标准计算改善率,优18例,良3例,可1例,差1例;术后1年优良率为91.3%。[结论]应用经皮椎间孔镜治疗腰椎融合术后相邻节段退变性疾病疗效确切,具有创伤小、手术时间短、恢复快、术后并发症少等优点。
[Abstract]:[objective] to investigate the clinical effect of percutaneous foramen technique in the treatment of adjacent segment degeneration after lumbar fusion. [methods] the clinical data of 23 patients with adjacent segmental degeneration after lumbar fusion were analyzed retrospectively from August 2010 to August 2015, and the results were evaluated by visual analogue score (visual analogue scale / score). The lumbar spine function was evaluated with (Japanese Orthopaedic Association Scores JOA score of Japan Orthopedic Association, the improvement rate of JOA was calculated, and the clinical curative effect was evaluated by modified Mac Nab standard one year after operation. [results] the operative time was 40 ~ 85 min (mean 55 min), blood loss was 525 ml (mean 10 ml), hospitalization time was 3 ~ 14 d (mean 7 d). All patients were followed up for 6 ~ 24 months (mean 13.5 months). The VAS score was (7.13 卤0.54) before operation, (2.05 卤0.34) on the 3rd day after operation, and (1.41 卤0.28) at the last follow-up. There were significant differences between preoperative and postoperative 3 days, and the scores of JOA were (9.89 卤0.53), (18.23 卤2.25) and (28.41 卤2.34), respectively. There was significant difference between preoperative and post-discharge follow-up (P0.01). According to the JOA score, the improvement rate was excellent in 18 cases, good in 3 cases, fair in 1 case and poor in 1 case, and the excellent and good rate was 91.3% one year after operation. [conclusion] Percutaneous foramen endoscopy is effective in the treatment of adjacent degenerative diseases after lumbar fusion. It has the advantages of less trauma, shorter operative time, faster recovery and less postoperative complications.
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本文编号：2149114
[Abstract]:[objective] to investigate the clinical effect of percutaneous foramen technique in the treatment of adjacent segment degeneration after lumbar fusion. [methods] the clinical data of 23 patients with adjacent segmental degeneration after lumbar fusion were analyzed retrospectively from August 2010 to August 2015, and the results were evaluated by visual analogue score (visual analogue scale / score). The lumbar spine function was evaluated with (Japanese Orthopaedic Association Scores JOA score of Japan Orthopedic Association, the improvement rate of JOA was calculated, and the clinical curative effect was evaluated by modified Mac Nab standard one year after operation. [results] the operative time was 40 ~ 85 min (mean 55 min), blood loss was 525 ml (mean 10 ml), hospitalization time was 3 ~ 14 d (mean 7 d). All patients were followed up for 6 ~ 24 months (mean 13.5 months). The VAS score was (7.13 卤0.54) before operation, (2.05 卤0.34) on the 3rd day after operation, and (1.41 卤0.28) at the last follow-up. There were significant differences between preoperative and postoperative 3 days, and the scores of JOA were (9.89 卤0.53), (18.23 卤2.25) and (28.41 卤2.34), respectively. There was significant difference between preoperative and post-discharge follow-up (P0.01). According to the JOA score, the improvement rate was excellent in 18 cases, good in 3 cases, fair in 1 case and poor in 1 case, and the excellent and good rate was 91.3% one year after operation. [conclusion] Percutaneous foramen endoscopy is effective in the treatment of adjacent degenerative diseases after lumbar fusion. It has the advantages of less trauma, shorter operative time, faster recovery and less postoperative complications.
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本文编号：2149114
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