摘要
目的:探讨微通道下经椎板间入路治疗对单节段退行性腰椎管狭窄症(DLSS)的影响。方法:选取2018年9月-2021年9月厦门大学附属第一医院收治的86例单节段DLSS患者。根据随机摸球法将其分为A、B组,各43例。A组给予微通道下经椎板间入路治疗,B组给予传统开放手术。比较两组围手术期指标,术前及术后1、3 d,1周肌酸磷酸激酶(CPK-MM),术前、术后3 d及3、6个月腰腿疼痛程度,术前及术后1、3、6个月腰椎功能及Oswestry功能障碍指数问卷表(ODI)评分,并发症及临床疗效。结果:A组住院时长、腰椎功能恢复至轻度功能障碍时间、手术时长均短于B组,术中出血量少于B组(P<0.05)。术后1、3 d及1周,两组CPK-MM水平均明显提高(P<0.05),A组CPK-MM水平明显低于B组(P<0.05)。术后3 d及3、6个月两组腰腿疼痛视觉模拟评分法(VAS)评分较术前均明显下降(P<0.05),术后3 d,A组腰腿疼痛VAS评分低于B组(P<0.05)。术后1、3、6个月,A组日本骨科协会(JOA)评分高于B组,ODI评分低于B组(P<0.05)。A组并发症发生率低于B组(P<0.05)。A组优良率为95.35%,B组优良率为83.72%,A组优良率比B组高,但两组优良率比较差异无统计学意义(P>0.05)。结论:微通道经椎板间入路治疗效果较好,可缩短住院时间、腰椎功能恢复时间、手术时间,减少出血量,对CPK-MM影响较小,能够减轻疼痛,对腰椎功能的改善具有重要作用,减少并发症的发生。
Objective:To investigate the effect of via interlaminar approach treatment under microchannel on single segment degenerative lumbar spinal stenosis(DLSS).Method:A total of 86 patients with single segment DLSS admitted to the First Affiliated Hospital of Xiamen University from September 2018 to September 2021 were selected.The patients were divided into group A and group B according to the random touch the ball method,43 cases in each group.Group A was given the via interlaminar approach treatment under microchannel,and group B was given the traditional open operation.The perioperative indexes,creatine phosphokinase(CPK-MM)before operation and 1,3 days and 1 week after operation,lumbar and leg pain degree before operation and 3 days,3 and 6 months after operation,lumbar function and Oswestry dysfunction index(ODI)score before operation and 1,3 and 6 months after operation,complications and clinical efficacy were compared between the two groups.Result:The length of hospitalization,lumbar function recovered to slight dysfunction and operation time in group A were shorter than those in group B,and the amount of intraoperative bleeding in group A was less than that in group B(P<0.05).And 1,3 days and 1 week after operation,the level of CPK-MM in both groups were significantly increased(P<0.05),the levels of CPK-MM in group A were significantly lower than those in group B(P<0.05).The visual analogue scale(VAS)score of lumbar and leg pain in the two groups at 3 days,3 months and 6 months after operation in both groups were significantly lower than those before operation(P<0.05).The VAS score of lumbar and leg pain in group A was lower than that in group B at 3 days after operation(P<0.05).And 1,3 and 6 months after operation,the score of Japan Orthopedic Association(JOA)in group A were higher than those in group B,and the ODI scores were lower than those in group B(P<0.05).The incidence of complications in group A was lower than that in group B(P<0.05).The excellent and good rate of group A was 95.35%,while that of group B was 83.72%,the excellent and good rate of group A was higher than that of group B,but there was no significant difference in excellent and good rate between the two groups(P>0.05).Conclusion:The effect of the via interlaminar approach treatment under microchannel approach is better,which can shorten the hospital stay,the recovery time of lumbar function,the operation time,reduce the amount of bleeding,it has less impact on CPK-MM,and can reduce pain,play an important role in improving lumbar function,and reduce the occurrence of complications.
作者
胡亚辉
肖德勇
郭剑峰
谭国伟
王占祥
HU Yahui;XIAO Deyong;GUO Jianfeng;TAN Guowei;WANG Zhanxiang(The First Affiliated Hospital of Xiamen University,Xiamen 361003,China;不详)
出处
《中外医学研究》
2022年第31期1-5,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
厦门市神经系统疾病临床医学研究中心项目(2021XMSLCYX01)。
关键词
微通道
椎板间入路
单节段退行性腰椎管狭窄症
腰椎功能
Microchannel
Interlaminar approach
Single segment degenerative lumbar spinal stenosis
Lumbar function
