Department of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain.
Neurosurg Focus. 2010 Jun;28(6):E3. doi: 10.3171/2010.3.FOCUS1034.
The aim of this study was to evaluate whether clinical improvement is noticeable after a minimally invasive procedure such as that used with the Aperius PercLID System in patients with degenerative lumbar spinal stenosis (DLSS) and neurogenic intermittent claudication (NIC).
The patients were treated with the aforementioned system at 3 different centers. The initial requirement to be included in the study was a minimum follow-up of 12 months. The authors studied 40 cases of DLSS in patients with NIC (age 72.7 +/- 8.08 years). Symptom severity, physical function, quality of life, and self-rated pain were assessed preoperatively and at the 12-month follow-up using the Zurich Claudication Questionnaire (ZCQ) and a visual analog scale. The procedure was conducted under spinal (35 patients) or local (5 patients) anesthesia, using biplanar fluoroscopy for visualization.
Single-level treatment was performed in 28 patients and 2-level treatment was performed in 12 patients. Based on time recordings in 24 cases, the mean procedural time was 19.9 +/- 5.0 minutes. The mean pain visual analog scale score improved significantly from 8.1 +/- 2.19 at baseline to 3.44 +/- 2.89 at the 1-year follow-up. The ZCQ score for patient satisfaction showed 90% of the patients being satisfied with the procedure. The mean rates of improvement in ZCQ score for symptom severity and physical function at 1 year were 38.7 +/- 33.3% and 33.8 +/- 29.7%, respectively, and both proved to be statistically significant. Most improvement was seen in mobility, pain/discomfort, and ability for self-care.
In this preliminary study, the Aperius system provided clinically significant improvement after 1 year of follow-up in patients older than 65 years with DLSS and NIC.
本研究旨在评估在患有退行性腰椎管狭窄症(DLSS)和神经源性间歇性跛行(NIC)的患者中,使用 Aperius PercLID 系统等微创治疗后是否会出现明显的临床改善。
患者在 3 个不同中心接受了上述系统的治疗。入组本研究的初始要求是至少随访 12 个月。作者研究了 40 例患有 NIC 的 DLSS 患者(年龄 72.7 +/- 8.08 岁)。使用苏黎世跛行问卷(ZCQ)和视觉模拟评分法,在术前和 12 个月随访时评估症状严重程度、身体功能、生活质量和自我报告的疼痛。该手术在脊髓(35 例患者)或局部麻醉(5 例患者)下进行,使用双平面透视进行可视化。
28 例患者进行了单节段治疗,12 例患者进行了双节段治疗。根据 24 例病例的时间记录,平均手术时间为 19.9 +/- 5.0 分钟。平均疼痛视觉模拟评分从基线时的 8.1 +/- 2.19 显著改善至 1 年随访时的 3.44 +/- 2.89。患者满意度的 ZCQ 评分显示,90%的患者对该手术满意。1 年后,症状严重程度和身体功能的 ZCQ 评分的平均改善率分别为 38.7 +/- 33.3%和 33.8 +/- 29.7%,均具有统计学意义。在移动能力、疼痛/不适和自理能力方面,改善最为明显。
在这项初步研究中,Aperius 系统在年龄大于 65 岁、患有 DLSS 和 NIC 的患者中,在 1 年随访时提供了显著的临床改善。