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腰椎管狭窄症的微创腰椎减压术:临床疗效及成本效益综述

Minimally invasive lumbar decompression for lumbar stenosis: review of clinical outcomes and cost effectiveness.

作者信息

Johans S J, Amin B Y, Mummaneni P V

机构信息

Department of Neurological Surgery Loyola University Medical Center, Maywood, IL, USA -

出版信息

J Neurosurg Sci. 2015 Mar;59(1):37-45. Epub 2014 Nov 5.

Abstract

Lumbar stenosis patients typically present with neurogenic claudication or radiculopathy. Studies have shown the benefit of surgical management of lumbar stenosis for patients who fail medical management. Surgical management traditionally involved an open laminectomy and foramenotomies. The emergence of minimally invasive spinal surgery has allowed for comparable clinical outcomes to open laminectomies, with the potential additional benefits of decreased blood loss, shorter hospital stay, decreased postoperative narcotic requirement, decreased rate of infection, and the potential benefit of decreasing the risk of postoperative instability. A shorter length of stay and faster return to work after minimally invasive lumbar decompression may result in the minimally invasive approach being more cost effective than an open approach. A literature review was performed to evaluate the clinical outcomes and cost effectiveness associated with minimally invasive decompression of lumbar stenosis.

摘要

腰椎管狭窄症患者通常表现为神经源性间歇性跛行或神经根病。研究表明,对于药物治疗无效的腰椎管狭窄症患者,手术治疗有益。传统的手术治疗包括开放式椎板切除术和椎间孔切开术。微创脊柱手术的出现使得其临床效果与开放式椎板切除术相当,还可能具有减少失血、缩短住院时间、降低术后麻醉需求、降低感染率以及降低术后不稳定风险等额外益处。微创腰椎减压术后较短的住院时间和更快的恢复工作能力可能使微创方法比开放方法更具成本效益。进行了一项文献综述,以评估与微创腰椎管减压相关的临床效果和成本效益。

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