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微减压术与椎板切除术治疗中央型腰椎管狭窄症的比较疗效:一项观察性研究的研究方案

Comparative effectiveness of microdecompression and laminectomy for central lumbar spinal stenosis: study protocol for an observational study.

作者信息

Nerland Ulf S, Jakola Asgeir S, Solheim Ole, Weber Clemens, Rao Vidar, Lønne Greger, Solberg Tore K, Salvesen Oyvind, Carlsen Sven M, Nygaard Oystein P, Gulati Sasha

机构信息

Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.

出版信息

BMJ Open. 2014 Mar 20;4(3):e004651. doi: 10.1136/bmjopen-2013-004651.

Abstract

INTRODUCTION

This observational study is designed to test the equivalence between the clinical effectiveness of microdecompression and laminectomy in the surgical treatment of central lumbar spinal stenosis. Lumbar spinal stenosis is the most frequent indication for spinal surgery in the elderly, and as the oldest segment of the population continues to grow its prevalence is likely to increase. However, data on surgical outcomes are limited. Open or wide decompressive laminectomy, often combined with medial facetectomy and foraminotomy, was formerly the standard treatment. In recent years a growing tendency towards less invasive decompressive procedures has emerged. At present, many spine surgeons perform microdecompression for central lumbar spinal stenosis.

METHODS AND ANALYSIS

Prospectively registered treatment and outcome data are obtained from the Norwegian Registry for Spine Surgery. The primary outcome measure is change in Oswestry disability index between baseline and 12-month follow-up. Secondary outcome measures are changes in health-related quality of life measured by the Euro-Qol-5D between baseline and 12-month follow-up, perioperative complications, and duration of surgical procedures and length of hospital stay.

ETHICS AND DISSEMINATION

The study has been evaluated and approved by the regional committee for medical research in central Norway and all participants provided written informed consent. The findings of this study will be disseminated through peer-reviewed publications.

TRIAL REGISTRATION NUMBER

Clinicaltrials.gov (NCT02006901).

摘要

引言

本观察性研究旨在检验显微减压术和椎板切除术在治疗中央型腰椎管狭窄症手术中的临床疗效是否等效。腰椎管狭窄症是老年人脊柱手术最常见的适应症,随着老年人口这一最大群体持续增长,其患病率可能会上升。然而,关于手术结果的数据有限。开放或广泛减压性椎板切除术,常联合内侧小关节切除术和椎间孔切开术,曾是标准治疗方法。近年来,出现了向侵入性较小的减压手术发展的趋势。目前,许多脊柱外科医生对中央型腰椎管狭窄症进行显微减压术。

方法与分析

前瞻性登记的治疗和结果数据来自挪威脊柱手术登记处。主要结局指标是从基线到12个月随访期间奥斯威斯功能障碍指数的变化。次要结局指标是从基线到12个月随访期间用欧洲五维健康量表测量的健康相关生活质量的变化、围手术期并发症、手术时间和住院时间。

伦理与传播

本研究已由挪威中部地区医学研究委员会评估并批准,所有参与者均提供了书面知情同意书。本研究结果将通过同行评审出版物进行传播。

试验注册号

Clinicaltrials.gov(NCT02006901)。

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