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经皮椎间孔镜下腰椎间盘切除减压术治疗老年腰椎管狭窄症

[Percutaneous intervertebral foramina endoscopic lumbar discectomy decompression for elder patients with lumbar spinal stenosis syndrome].

作者信息

Hu De-Xin, Zheng Qi, Zhu Bo, Ying Xiao-Zhang, Wang Yi-Fan

出版信息

Zhongguo Gu Shang. 2014 Mar;27(3):194-8.

PMID:24974419
Abstract

OBJECTIVE

To evaluate the clinical outcomes of percutaneous intervertebral foramina endoscopic lumbar discectomy for elder patients with lumbar spinal stenosis syndrome.

METHODS

From July 2006 to July 2011, 60 elder patients with lumbar spinal stenosis syndrome were treated with surgical operation, including 32 males and 28 females with an average age of (66.7 +/- 2.5) years old ranging from 72 to 83 years. These patients were divided into the traditional surgery group and percutaneous intervertebral foramina endoscopic discectomy groups (PTED group), 30 cases in each group. The index of the preoperative and postoperative, operative incision visual analogue scale (VAS) of two groups were compared. The Oswestry disability index (ODI) of two groups at 6, 24 months of the follow-up were also evaluated on activity of daily living.

RESULTS

The average operative time, the average blood loss, the number of cases using analgesic drug, hospitalization time of PTED group were better than those of the traditional surgery group (P < 0.05). The improvement of incision VAS in PTED group was better than that in the traditional surgery group (P < 0.05). All patients were followed up for 24 months at least. The ODI at 1, 24 month after operation were better than that of preoperative in two group respectively (P < 0.05), but the improvement of PTED group was better than that of the traditional surgery group (P < 0.05).

CONCLUSION

PTED has the advantages of smaller incision, less bleeding, less postoperative stay and hospitalization time, tissue trauma and quicker recovery. It is a safe and efficacious minimally invasive surgical technique for elder patients with lumbar spinal stenosis syndrome.

摘要

目的

评估经皮椎间孔镜下腰椎间盘切除术治疗老年腰椎管狭窄症患者的临床疗效。

方法

2006年7月至2011年7月,60例老年腰椎管狭窄症患者接受手术治疗,其中男性32例,女性28例,平均年龄(66.7±2.5)岁,年龄范围72至83岁。将这些患者分为传统手术组和经皮椎间孔镜下椎间盘切除术组(PTED组),每组30例。比较两组术前、术后指标,手术切口视觉模拟评分(VAS)。随访两组术后6个月、24个月的日常生活活动能力Oswestry功能障碍指数(ODI)。

结果

PTED组平均手术时间、平均出血量、使用镇痛药例数、住院时间均优于传统手术组(P<0.05)。PTED组切口VAS改善情况优于传统手术组(P<0.05)。所有患者至少随访24个月。两组术后1个月、24个月的ODI均分别优于术前(P<0.05),但PTED组改善情况优于传统手术组(P<0.05)。

结论

PTED具有切口小、出血少、术后卧床及住院时间短、组织创伤小、恢复快等优点。是治疗老年腰椎管狭窄症患者安全有效的微创手术技术。

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