摘要
目的 分析单通道内镜下单侧入路双侧减压(endo-ULBD)对腰椎管狭窄症(LSS)的疗效。方法 回顾性分析2020年3月至2022年10月临沂市中心医院收入单节段LSS患者共42例的临床资料,结合不同术式分成对照组(开放术式)和观察组(单通道内镜单侧入路双侧减压治疗)分别包含21例,比较两组在不同手术方案下的各项手术指标;术前和术后不同时间的腰腿疼痛视觉模拟评分(VAS)及腰椎Oswestry功能障碍指数(ODI);术前及术后1个月的腰椎活动度情况。结果 观察组的住院时间短于对照组,失血量少于对照组,差异有统计学意义(P<0.05)。术前,两组VAS评分相比差异无统计学意义(P>0.05);术后1 d、术后2 d、术后3 d、术后7 d及术后1个月,观察组的VAS评分均低于对照组,差异有统计学意义(P<0.05)。术前,两组ODI评分相比差异无统计学意义(P>0.05);术后1 d、术后2 d、术后3 d、术后7 d及术后1个月,观察组的ODI评分均低于对照组,差异有统计学意义(P<0.05)。术前,两组屈伸、侧弯、旋转时的腰椎活动度相比差异无统计学意义(P>0.05);术后,观察组屈伸、侧弯、旋转时的腰椎活动度均高出对照组,差异有统计学意义(P<0.05)。结论 单通道内镜单侧入路双侧减压对LSS患者疗效较为理想,能减少其失血量,缩短住院时间,减轻疼痛症状和腰部功能障碍,值得临床应用。
Objective To analyze the efficacy of single-site endoscopic unilateral bilateral decompression(endo-ULBD)for lumbar spinal stenosis(LSS). Methods The clinical data of 42 patients with single-site LSS in Linyi Central Hospital from March 2020 to October 2022 were retrospectively analyzed, and combined with different surgical methods, they were divided into a control group(open surgery) and an observation group(single-site endoscopic bilateral decompression treatment via unilateral approach), including 21 cases, respectively. The surgical indexes of the two groups under different surgical plans, visual analog scale(VAS), lumbar Oswestry disability index(ODI) at a different time before and after surgery, and Lumbar motion before and 1 month after surgery were compared. Results The hospitalization time of the observation group was shorter than the control group, and the blood loss was less than the control group, the difference was statistically significant(P<0.05). Before surgery,there was no significant difference in VAS scores between the two groups(P>0.05). On 1 day, 2 days, 3 days, 7 days, and 1 month after the operation, the VAS scores of the observation group were lower than those of the control group, and the differences were statistically significant(P<0.05). Before surgery, there was no significant difference in ODI scores between the two groups(P>0.05). On 1 day, 2 days, 3 days, 7 days, and 1 month after the operation, the ODI scores of the observation group were lower than those of the control group, and the differences were statistically significant(P<0.05). Before surgery, there was no significant difference in lumbar motion during flexion and extension, lateral bending, and rotation between the two groups(P>0.05). After surgery, lumbar motion in flexion-extension, lateral bending, and rotation in the observation group were higher than that in the control group, the difference was statistically significant(P<0.05). Conclusion Single-site endoscopic bilateral decompression via unilateral approach has an ideal effect on patients with LSS, which can reduce blood loss, shorten the length of hospital stay, relieve pain symptoms and waist dysfunction, and is worthy of clinical application.
作者
刘兆斌
LIU Zhaobin(Department of Pain,Linyi Central Hospital,Linyi Shandong 276400,China)
出处
《临床研究》
2023年第2期23-27,共5页
Clinical Research
关键词
腰椎管狭窄症
单通道内镜
单侧入路双侧减压
疼痛
腰椎活动度
lumbar spinal stenosis
single-site endoscope
unilateral approach and bilateral decompression
pain
lumbar motion
