摘要
目的比较老年性腰椎管狭窄症患者采用传统手术与经皮椎间孔镜治疗的临床效果。方法老年性腰椎管狭窄症患者88例，随机分为传统手术组与微创手术组，每组44例。传统手术组患者全身麻醉后在X线机透视下确定腰椎病变部位，暴露腰椎间盘棘突，对病椎增生韧带进行切除。微创手术组患者局部麻醉后，利用x线机确定患者腰椎病变部位，扩大椎间孔距、置入椎间孔镜后，在椎间孔镜下清除患者腰椎间盘突出的髓核组织、黄韧带。比较两组患者手术时间、下床活动时间、平均住院时间以及两组患者治疗前和出院3周后腰椎活动功能（JOA）评分情况。结果微创手术组手术时间、下床活动时间、平均住院时间均明显短于传统手术组（P〈0．05）；微创手术组患者出院3周后腰椎活动功能（JOA）评分明显优于传统手术组（24.3±5．1vs19．3±4．4，P〈0．05）。结论对于老年性腰椎管狭窄症患者给予经皮椎间孔镜治疗较传统手术治疗能更有效地促进腰椎活动功能的恢复。
Objective To compare the efficacy between conventional operation and percutaneous in- tervertebral foramen endoscopy lumbar disceetomy in the treatment of elderly patients with lumbar spinal steno- sis. Methods Eighty-eight elderly patients with lumbar spinal stenosis were randomly divided into conven- tional operation group and minimally invasive group, 44 cases in each group. Patients in the conventional opera- tion group received the resection of the hyperplasia of ligament followed determinating the lumbar lesion after general anesthesia under X-ray. Patients in the minimally invasive group were removed nucleus pulposus, fla- val ligament at the herniated discs under intervertebral foramcn endoscopy after local anesthesia. The operation time, ambulation time, average hospitalization time and the change of lumbar motor function （JOA） score before operation and 3 weeks after hospital discharge were compared between the two groups. Results The operation time, ambulation time and hospitalization time were significantly shorter in the minimally invasive group than those in the conventional operation group （P〈0.05）. JOA score was significantly better in the minimally inva- sive group than that in the conventional operation group at 3 weeks after hospital discharge （24.3±5.1 vs 19.3± 4.4, P〈0.05）. Conclusion Percutaneous intervertebral foramen endoscopy therapy can effectively promote the recovery of motor function of the lumbar spine in the elderly patients with lumbar spinal stenosis, compared with conventional operation.
出处
《实用疼痛学杂志》
2017年第5期328-331,共4页
Pain Clinic Journal
关键词
椎管狭窄
老年人
经皮椎间孔镜
Spinal stenosis
Aged
Percutaneous intervertebral foramen endoscopy
