显微镜辅助通道下单侧开窗双侧减压治疗腰椎管狭窄症的早期疗效分析
摘要
目的:研究显微镜辅助METRx通道下单侧开窗双侧减压(ULBD)治疗退行性腰椎管狭窄症的临床疗效。方法:对本院自2015年5月至2017年12月期间收治的16例退变性腰椎管狭窄症患者应用显微镜辅助METRx通道下单侧开窗双侧减压(ULBD)术治疗,统计有关手术观察指标(包括手术刀口长度、术中出血量、术后下地时间)及围术期并发症等指标变化,根据VAS和ODI评定手术效果,应用t检验进行统计学分析。结果:所有患者均顺利完成手术,手术刀口均一期甲级愈合,无椎管内感染、血肿形成、神经损伤等并发症,16例病例均获得术后3~6个月随访,取得较好疗效,该手术方式创伤较小,出血较少,术后疼痛轻,恢复较快。结论:显微镜辅助METRx通道下单侧开窗双侧减压(ULBD)作为微创手术,创伤小,减压充分,对脊柱稳定性影响小,无需内固定,术中出血少,术后疼痛轻,恢复快,具有明显的临床优势,值得临床推广。
引文
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[11]黎庆初,胡辉林,杨渊.显微内窥镜下改良工作通道单侧入路双侧减压治疗退变性腰椎管狭窄症[J].中国脊柱脊髓杂志,2010,20(1):15-18.
[12]刘鹏,孙庆,秦廷正,等.成人脊柱标本单侧椎板入路双侧减压前后腰椎管参数CT测量结果比较[J].吉林大学学报:医学版,2015,41(5):1050-1054.
[2]张良,孙常太,王强,等.老年退行性腰椎管狭窄症患者全椎板切除术后远期X线变化[J].中国脊柱脊髓杂志,2007,17(10):735-738.
[3]Deyo RA,Mirza SK,Martin BI,et al.Trends,major medical complications,and charges associated with surgery for lumbar spinal stenosis in older adults[J].Journal of the American Medical Association,2011,306(10):1259-1265.
[4]Deschuyffeleer S,Leijssen P,Bellemans J.Unilateral laminotomy with bilateral decompression for lumbar spinal stenosis:short-term risks in elderly individuals[J].Acta Orthopaedica Belgica,2012,78(5):672-677.
[5]Guiot BH,Khoo LT,Fessler RG.A minimally invasive technique for decompression of the lumbar spine[J].Spine(Phila Pa 1976),2002,27(4):432-438.
[6]Toyoda H,Nakamura H,Konishi S,et al.Clinical outcome of microsurgical bilateral decompression via unilateral approach for lumbar canal stenosis:minimum five-year follow-up[J].Spine(Phila Pa 1976),2011,36(5):410-415.
[7]Rose DS,O’Toole JE,Eiehhok KM,et al.Minimally invasive lumbar spinal decompression in the elderly:outcomes of 50patients aged 75years and older[J].Neurosurgery,2007,60(3):503-509.
[8]Young S,Veerapen RO,Laoire SA.Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy:preliminary report[J].Neurosurgery,1988,23(5):628-633.
[9]Asgar T-adie F,Khoo LT.Minimally invasive operative management for lumbar spinal stenosis:overview of early and long-term outcomes[J].Orthop Clin North Am,2007,38(10):387-399.
[10]周跃,王健,李长青,等.内镜下经单侧入路行双侧椎管减压治疗退变性腰椎管狭窄症[J].中华显微外科杂志,2009,32(1):19-22.
[11]黎庆初,胡辉林,杨渊.显微内窥镜下改良工作通道单侧入路双侧减压治疗退变性腰椎管狭窄症[J].中国脊柱脊髓杂志,2010,20(1):15-18.
[12]刘鹏,孙庆,秦廷正,等.成人脊柱标本单侧椎板入路双侧减压前后腰椎管参数CT测量结果比较[J].吉林大学学报:医学版,2015,41(5):1050-1054.