摘要
目的比较单侧双通道内镜(UBE)技术与经皮内镜椎板间入路腰椎管减压术(PEID)在老年腰椎管狭窄症(LSS)的临床疗效。方法回顾性分析2018年7月至2021年10月自贡市第一人民医院收治的腰椎管狭窄症患者99例。患者自愿选择,分为A、B两组。A组共纳入51例,采用UBE技术治疗;B组共纳入48例,采用PEID治疗。记录两组病例出血量、手术时间、术中透视次数、住院时间及并发症等情况。术前和末次随访时,以疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)进行评估。末次随访时,以改良MacNab标准评估治疗效果。结果两组术中均发生因硬膜囊撕裂1例,无血管损伤、神经损伤等严重并发症;术后手术切口均一期愈合。A组出血量明显多于B组(P<0.05),A组手术时间明显少于B组(P<0.05)。两种术中透视次数比较差异无统计学意义(P>0.05)。B组住院时间明显多于A组(P<0.05)。术前、末次随访时两组腰痛VAS评分,腿痛VAS评分及ODI指数比较无统计学意义(P>0.05)。末次随访时两组按改良MacNab标准优良率比较差异无统计学意义(P>0.05)。A组2例出现并发症,B组8例出现并发症,均经对症治疗后改善。两组并发症发生率差异有统计学意义(P<0.05)。结论UBE技术及PEID治疗老年腰椎管狭窄症均能取得良好临床疗效,但PEID并发症率相对较高。
Objective To compare the clinical efficacy of unilateral biportal endoscopy(UBE)and percutaneous endoscopic interlaminar decompression(PEID)in the treatment of lumbar spinal stenosis.Methods Retrospective analysis was made on 99 patients with lumbar spinal stenosis admitted to our hospital from July 2018 to October 2021.Patients were selected voluntarily and divided into two groups:A and B.In group A,51 cases were enrolled and treated with UBE technique;48 patients in group B were treated with PEID.The bleed loss,operation time,number of intraoperative fluoroscopy,hospital stay and complications of the two groups were recorded.Visual analog scale(VAS)and Oswestry dysfunction index(ODI)were used for evaluation before operation and at the last follow-up.At the last follow-up,the treatment effect was evaluated by the modified MacNab standard.Results There was 1 case of dural sac tear in both groups,without serious complications such as vascular injury and nerve injury;The incision healed in one stage after operation.The bleed loss in group A was significantly more than that in group B(P<0.05),and the operation time in group A was significantly less than that in group B(P<0.05).There was no significant difference in the number of intraoperative fluoroscopy between the two methods(P>0.05).The hospital stay of group B was significantly longer than that of group A(P<0.05).There was no significant difference in VAS score of low back pain,VAS score of leg pain and ODI index between the two groups before operation and at the last follow-up(P>0.05).At the last follow-up,there was no significant difference between the two groups according to the improved MacNab standard(P>0.05).There were 2 complications in group A and 8 complications in group B,which were improved after treatment.There was significant difference in the incidence of complications between the two groups(P<0.05).Conclusion UBE technology and PEID can achieve good clinical effect in the treatment of lumbar spinal stenosis in the elderly,but the complication rate of PEID is relatively high.
作者
陈康
何仁建
罗园超
杨富国
CHEN Kang;HE Renjian;LUO Yuanchao;YANG Fuguo(Department of Orthopedics,The First People′s Hospital of Zigong,Zigong 643000)
出处
《颈腰痛杂志》
2025年第1期19-24,共6页
The Journal of Cervicodynia and Lumbodynia
基金
四川省医学科研课题计划(S20057)
自贡市科学技术局重点科技计划项目(2021YLSF01)。
