Wen Bingtao, Zhang Xifeng, Zhang Lin, Huang Peng, Zheng Guoquan
Department of Orthopedics, Peking University International Hospital Department of Orthopedics, Chinese PLA General Hospital, Beijing, China.
Medicine (Baltimore). 2016 Dec;95(50):e5186. doi: 10.1097/MD.0000000000005186.
This study aimed to evaluate the safety and curative effect of percutaneous endoscopic transforaminal lumbar spinal canal decompression in the treatment of lumbar spinal stenosis.This retrospective study recruited 64 patients with lumbar spinal stenosis who underwent percutaneous endoscopic lumbar spinal canal decompression via surgical approach of posterolateral intervertebral foramen. The postoperation neurological function and pain status were evaluated by the visual analog scale (VAS) score of pain and the Oswestry disability index (ODI), and the patient satisfaction was evaluated according to the MacNab outcome criteria. The data, including preoperative comorbidities, operation time, the quantity of bleeding, bed rest time, and intraoperative and postoperative complications, were recorded.The mean operation time was 78 min, the mean quantity of bleeding was 20 mL and bed rest time was 6 h to 3 days. All patients were followed-up for 4 months to 5 years. The mean preoperative VAS score was 7.7 ± 1.2, while postoperative 3 months, 6 months, and final follow-up VAS scores were 2.8 ± 0.7, 2.1 ± 0.6, and 0.8 ± 0.6, respectively (P < 0.001). The mean preoperative ODI score was 72.4 ± 1.2, while postoperative 3 months, 6 months, and final follow-up ODI scores were 29.7 ± 4.9, 23.9 ± 4.0, and 12.5 ± 3.9, respectively (P < 0.001). The excellent and good rate reached 73.4% at the final follow-up.The percutaneous endoscopic transforaminal lumbar spinal canal decompression is an easy, safe, and effective minimally invasive surgery for patients with lumbar spinal stenosis.
本研究旨在评估经皮内镜下经椎间孔腰椎管减压术治疗腰椎管狭窄症的安全性和疗效。本回顾性研究纳入了64例腰椎管狭窄症患者，这些患者均通过后外侧椎间孔手术入路接受了经皮内镜下腰椎管减压术。术后通过疼痛视觉模拟量表（VAS）评分和Oswestry功能障碍指数（ODI）评估神经功能和疼痛状况，并根据MacNab疗效标准评估患者满意度。记录术前合并症、手术时间、出血量、卧床时间以及术中和术后并发症等数据。平均手术时间为78分钟，平均出血量为20毫升，卧床时间为6小时至3天。所有患者均随访4个月至5年。术前VAS评分平均为7.7±1.2，而术后3个月、6个月及末次随访时的VAS评分分别为2.8±0.7、2.1±0.6和0.8±0.6（P<0.001）。术前ODI评分平均为72.4±1.2，而术后3个月、6个月及末次随访时的ODI评分分别为29.7±4.9、23.9±4.0和12.5±3.9（P<0.001）。末次随访时优良率达73.4%。经皮内镜下经椎间孔腰椎管减压术对于腰椎管狭窄症患者是一种简便、安全且有效的微创手术。
