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轻度椎板间减压治疗腰椎管狭窄症:手术描述和 1 年随访的病例系列。

mild Interlaminar decompression for the treatment of lumbar spinal stenosis: procedure description and case series with 1-year follow-up.

机构信息

Department of Radiology, School of Medicine, University of California-San Diego, CA 92103, USA.

出版信息

Clin J Pain. 2012 Jul;28(6):534-8. doi: 10.1097/AJP.0b013e31823aaa9d.

Abstract

OBJECTIVES

mild interlaminar decompression is a minimally invasive procedure for the treatment of patients with symptomatic lumbar spinal stenosis. This report describes the mild procedure and presents 1-year clinical outcomes of patients treated with mild.

METHODS

mild treats lumbar spinal stenosis by removing portions of the lamina and ligamentum flavum to restore space in the lumbar spine. The procedure is conducted under fluoroscopic guidance, and is performed with moderate sedation. One-year follow-up was obtained for 17 patients treated with the mild procedure. Clinical evaluations were conducted at baseline and at 1-year follow-up with the 10-point Visual Analog Score and Oswestry Disability Index.

RESULTS

mild treatments were completed with no major device-related or procedure-related complications. The baseline mean Visual Analog Score of 7.6 improved at 1 year after the procedure to 2.3, a decrease of 5.4 cm points, or an average percentage decrease of 70.0%. Average baseline Oswestry Disability Index of 48.4 improved to 21.7 at 1 year, an improvement of 26.6 points.

DISCUSSION

The mild technique provides an attractive early option for the treatment of symptomatic lumbar spinal stenosis after failed injection therapy, but before more invasive surgical treatment. For 17 patients with 1-year follow-up, the mild procedure provided significant pain relief and increased mobility. This procedure leaves no implants behind, and therefore does not limit subsequent, more invasive procedures that require implants.

摘要

目的

轻度椎板间减压术是一种微创治疗方法,适用于治疗有症状的腰椎管狭窄症患者。本报告介绍了该微创手术,并报告了接受轻度治疗的患者 1 年的临床结果。

方法

轻度治疗通过切除部分椎板和黄韧带来恢复腰椎间的空间,从而治疗腰椎管狭窄症。该手术在透视引导下进行,在中度镇静下进行。对 17 例接受轻度治疗的患者进行了 1 年的随访。在基线和 1 年随访时,采用 10 分视觉模拟评分和 Oswestry 残疾指数进行临床评估。

结果

轻度治疗完成,无重大器械相关或手术相关并发症。基线平均视觉模拟评分(VAS)为 7.6,术后 1 年改善至 2.3,降低了 5.4cm 点,平均降低了 70.0%。平均基线 Oswestry 残疾指数(ODI)从 48.4 改善至 1 年时的 21.7,改善了 26.6 分。

讨论

在注射治疗失败后、更具侵袭性的手术治疗之前,轻度技术为治疗有症状的腰椎管狭窄症提供了一种有吸引力的早期选择。在 17 例接受 1 年随访的患者中,轻度治疗显著缓解了疼痛并提高了活动能力。该手术不留下任何植入物,因此不会限制随后需要植入物的更具侵袭性的手术。

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