You Hao, Yang Quan-Zhong, Wu Wei-Guo, Wang Fei, Zhao Liang-Liang
Department of Orthopaedics, Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing 100071, China.
Department of Orthopaedics, Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing 100071, China;
Zhongguo Gu Shang. 2019 Mar 25;32(3):248-253. doi: 10.3969/j.issn.1003-0034.2019.03.011.
To explore the clinical early-middle stage clinical effect of percutaneous spinal endoscopic with the technique of Broad Easy Immediate Surgery(BEIS) for lumbar spinal stenosis.
The clinical data of 57 patients with lumbar spinal stenosis treated by surgery from June 2015 to June 2016 were retrospectively analyzed, including 32 cases treated by percutaneous spinal endoscopic with the technique of BEIS (minimally invasive group) and 25 cases by posterior approach of lumbar pedicle screws internal fixation and intervertebral disc excision with bone graft fusion surgery (open surgery group). The pre-operative general data such as age, Body Mass Index (BMI) and etc. were analysed and compared. The operation time, intraoperative blood loss, hospitalization time of the two groups were analyzed. Visual analogue score(VAS), Oswestry Disability Index(ODI), Japanese Orthopedic Association Score(JOA) of preoperative and at 1 week, 1 month, 3 months, 6 months after surgery were used to evaluate the clinical outcome of the two group.
All the operations were successful and all the patients recovered smoothly without severe complications, all the wounds got good healing. The pain of the lumbar and lower limb had been improved after surgery. All the patients were followed up more than 6 months with an average of(10.65±3.38) months. There was no significant difference in general data such as age, BMI, and etc. between two groups(>0.05). There were significant differences in VAS, ODI between two groups at 1 week, 1, 3, 6 months after surgery(<0.05). The postoperative lumbar pain of the minimally invasive group had been better improved than the open surgery group. However, there was no significant difference in JOA between two groups at 1 week, 1, 3, 6 months after surgery(>0.05). Intraoperative blood loss and hospitalization time of minimally invasive group was less than that of open surgery group.
BEIS technique has the advantage of less trauma, less bleeding for lumbar stenosis when compared to open surgery. It can better alleviate the postoperative local lumbar pain, and early-middle clinical effect is equivalent to open surgery, so it can be used as a safe and effective surgical treatment for lumbar spinal stenosis.
探讨经皮脊柱内镜下宽通道简易即刻手术（BEIS）技术治疗腰椎管狭窄症的临床早中期疗效。
回顾性分析2015年6月至2016年6月接受手术治疗的57例腰椎管狭窄症患者的临床资料，其中32例采用经皮脊柱内镜下BEIS技术治疗（微创组），25例采用后路腰椎椎弓根螺钉内固定及椎间盘切除植骨融合手术治疗（开放手术组）。分析并比较两组患者术前的年龄、体重指数（BMI）等一般资料。分析两组患者的手术时间、术中出血量、住院时间。采用视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）、日本骨科学会评分（JOA）对两组患者术前及术后1周、1个月、3个月、6个月的临床疗效进行评价。
所有手术均成功，患者均顺利康复，无严重并发症，所有伤口愈合良好。术后腰及下肢疼痛均有改善。所有患者均获随访6个月以上，平均（10.65±3.38）个月。两组患者年龄、BMI等一般资料比较，差异无统计学意义（>0.05）。两组患者术后1周、1个月、3个月、6个月的VAS、ODI比较，差异有统计学意义（<0.05）。微创组术后腰部疼痛改善优于开放手术组。但两组患者术后1周、1个月、3个月、6个月的JOA比较，差异无统计学意义（>0.05）。微创组术中出血量及住院时间少于开放手术组。
与开放手术相比，BEIS技术治疗腰椎管狭窄症具有创伤小、出血少的优点。能更好地缓解术后局部腰部疼痛，早中期临床疗效与开放手术相当，可作为腰椎管狭窄症安全有效的手术治疗方法。
