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腰椎管狭窄症患者单侧入路双侧减压与经典椎板切除术的比较:一项回顾性临床研究

A Comparison of Bilateral Decompression via Unilateral Approach and Classic Laminectomy in Patients with Lumbar Spinal Stenosis: A retrospective Clinical Study.

作者信息

Yaman Onur, Ozdemir Nail, Dagli Ahmet Turan, Acar Erdem, Dalbayrak Sedat, Temiz Cuneyt

机构信息

Tepecik Education and Training Hospital, Clinic of Neurosurgery, Izmir, Turkey.

出版信息

Turk Neurosurg. 2015;25(2):239-45. doi: 10.5137/1019-5149.JTN.8710-13.1.

Abstract

AIM

Bilateral decompression via unilateral approach is one of the minimally invasive methods used for degenerative spinal stenosis. The aim of this retrospective study was to observe the clinical and radiological results of classic laminectomy and bilateral decompression via unilateral approach applied for lumbar stenosis.

MATERIAL AND METHODS

The data of 40 patients who underwent surgical treatment for lumbar spinal stenosis with different techniques was reviewed retrospectively. The patients were divided into 2 groups according to the surgical technique. In the first group, patients underwent classic laminectomy, while in the second group patients underwent bilateral decompression via unilateral approach. Preoperative and postoperative computed tomography section areas of both groups were examined. Visual analogue scale (VAS) was used to evaluate low back and leg pain in preoperative and postoperative 1, 6, and 12 months. The two groups were compared in respect of surgery time and bleeding.

RESULTS

In both groups, postoperative low back and leg pain VAS scores declined compared to the preoperative condition. Low back pain VAS scores were lower at postoperartive 1, 6, and 12 months. The bleeding was higher in the 1st group, whereas the surgery time was higher in the 2nd group.

CONCLUSION

Bilateral decompression through unilateral approach is an effective method without instability effect, which provides sufficient decompression in the degenerative stenosis and increases patient comfort in the postoperative period.

摘要

目的

单侧入路双侧减压是用于退行性腰椎管狭窄症的微创方法之一。本回顾性研究的目的是观察经典椎板切除术和单侧入路双侧减压治疗腰椎管狭窄症的临床及影像学结果。

材料与方法

回顾性分析40例采用不同技术接受腰椎管狭窄症手术治疗患者的数据。根据手术技术将患者分为2组。第一组患者接受经典椎板切除术,而第二组患者接受单侧入路双侧减压。检查两组术前和术后的计算机断层扫描截面积。采用视觉模拟评分法(VAS)评估术前及术后1、6和12个月时的腰腿痛情况。比较两组的手术时间和出血量。

结果

两组术后腰腿痛VAS评分均较术前下降。术后1、6和12个月时腰背痛VAS评分较低。第一组出血量较多,而第二组手术时间较长。

结论

单侧入路双侧减压是一种有效的方法,无不稳定效应,能为退行性狭窄提供充分减压,并提高患者术后舒适度。

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