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采用 TESSYS-ISEE 技术行 270 度椎管减压治疗腰椎管狭窄症合并椎间盘突出症的早期疗效。

Early outcomes of 270-degree spinal canal decompression by using TESSYS-ISEE technique in patients with lumbar spinal stenosis combined with disk herniation.

机构信息

Orthopaedic Department, Wuhan General Hospital of PLA, #627 Wuluo Road, Hongshan District, Wuhan, Hubei, China.

Orthopaedic Department, Hubei Province Traditional Chinese Medicine College, Wuhan, China.

出版信息

Eur Spine J. 2019 Jan;28(1):78-86. doi: 10.1007/s00586-018-5655-4. Epub 2018 Jun 16.

Abstract

PURPOSE

Traditional open approach is an efficient way to treat lumbar spinal stenosis (SS) combined with disk herniation (DH); however, risk factors such as advanced age, osteoporosis etc. are associated with the complications after the surgery. This study aims to analyze the early clinical and radiological outcomes of treatment on SS&DH by using newly developed minimal invasive TESSYS-ISEE technique.

METHODS

Patients with limp and unilateral lower limb radiculopathy underwent minimal invasive surgery by using TESSYS-ISEE technique. The visual analogue scale score (VAS) and Oswestry Disability Index (ODI) were evaluated before operation and 1, 3, 6 and 12 months after surgery. The clinical global outcomes were also evaluated using modified MacNab criteria after surgery.

RESULTS

A total of 32 cases underwent operation by using TESSYS-ISEE technique from December 2016 to December 2017. The mean age for the study group was 53.9 ± 11.14 years and the ratio between male and female was 1.29:1; Mean follow-up of the study was 7.78 ± 3.48 months and mean estimated blood loss was 11.41 ± 4.79 mL per-level. VAS leg score improved from 8.44 ± 0.98 to 2.18 ± 0.75 (P < 0.001), VAS back score improved from 4.44 ± 0.95 to 1.57 ± 0.54 (P < 0.001), and ODI improved from 73.88 ± 5.95 to 29.04 ± 7.48 (P < 0.001). The success rate was 90.7%. There were no serious complications during follow-up. Two patients experienced dysesthesia and one patient required revision surgery.

CONCLUSIONS

It is safe and minimal-invasively to treat SS&DH by using TESSYS-ISEE technique. However, potential complications still require careful consideration and further evaluation. These slides can be retrieved under Electronic Supplementary material.

摘要

目的

传统的开放式手术是治疗腰椎管狭窄症(SS)合并椎间盘突出症(DH)的有效方法;然而,高龄、骨质疏松症等危险因素与手术后的并发症有关。本研究旨在分析应用新开发的微创 TESSYS-ISEE 技术治疗 SS&DH 的早期临床和影像学结果。

方法

对单侧下肢根性跛行的患者采用 TESSYS-ISEE 技术行微创手术。在术前及术后 1、3、6 和 12 个月,采用视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)进行评估。术后采用改良 MacNab 标准评估临床总体疗效。

结果

2016 年 12 月至 2017 年 12 月,共 32 例患者采用 TESSYS-ISEE 技术行手术治疗。研究组平均年龄为 53.9±11.14 岁,男女比例为 1.29:1;平均随访时间为 7.78±3.48 个月,每节段估计失血量为 11.41±4.79mL。术后,VAS 下肢评分从 8.44±0.98 分改善至 2.18±0.75 分(P<0.001),VAS 腰背评分从 4.44±0.95 分改善至 1.57±0.54 分(P<0.001),ODI 从 73.88±5.95 分改善至 29.04±7.48 分(P<0.001)。手术成功率为 90.7%。随访期间无严重并发症发生。2 例患者出现感觉异常,1 例患者需要翻修手术。

结论

应用 TESSYS-ISEE 技术治疗 SS&DH 安全微创,但潜在并发症仍需仔细考虑和进一步评估。这些幻灯片可以在电子补充材料中找到。

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