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经皮内镜下经椎间孔腰椎体间融合术治疗腰椎管狭窄症:7 例患者 12 个月随访的初步报告。

Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spinal Stenosis: Preliminary Report of Seven Cases with 12-Month Follow-Up.

机构信息

Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, 100020, China.

出版信息

Biomed Res Int. 2019 Mar 24;2019:3091459. doi: 10.1155/2019/3091459. eCollection 2019.

Abstract

PURPOSE

The objective of this study was to investigate the preliminary effectiveness of percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) for the treatment of lumbar spinal stenosis (LSS).

METHODS

From September 2016 to June 2017, a series of seven patients consisting of six females and one male with an average age of 55.25 years (range 43-77 years) who were diagnosed with LSS were involved in this study. All patients were treated by PE-TLIF. During perioperative and follow-up period, demographic data, operation time, intraoperative blood loss, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria were evaluated and perioperative complications were documented.

RESULTS

All patients were followed up for more than 12 months, with an average follow-up time of 15 (range 12-21) months. The mean VAS of back pain was 7.43 (range 6-8) preoperatively and 0.86 (range 0-2) at the final follow-up. The mean VAS of leg pain was 6.14 (range 4-9) preoperatively and 0.71 (range 0-1) at the final follow-up. The mean ODI was 53.57% (range 38%-63%) preoperatively and 15.57% (range 5%-26%) at the final follow-up. In three-month follow-up, continuous bone trabeculae bridging between intervertebral bodies was seen in 3 cases, and the remaining 4 cases could identify continuous bone trabeculae bridging at 6-month follow-up, reaching the standard of spinal intervertebral fusion. At the final follow-up, 4 patients were rated as excellent (4/7) and 3 patients were rated as good (3/7) according to the modified MacNab criteria.

CONCLUSIONS

Our study suggested that percutaneous endoscopic transforaminal lumbar interbody fusion could acquire satisfactory treatment effects for the patients with lumbar spinal stenosis, even for the patient who could not afford general anesthesia.

摘要

目的

本研究旨在探讨经皮内镜椎间孔腰椎体间融合术(PE-TLIF)治疗腰椎管狭窄症(LSS)的初步疗效。

方法

本研究纳入了 2016 年 9 月至 2017 年 6 月期间的 7 例患者,其中包括 6 名女性和 1 名男性,平均年龄为 55.25 岁(范围为 43-77 岁),均被诊断为 LSS。所有患者均接受了 PE-TLIF 治疗。在围手术期和随访期间,评估了患者的人口统计学数据、手术时间、术中出血量、视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)和改良 MacNab 标准,并记录了围手术期并发症。

结果

所有患者均获得了超过 12 个月的随访,平均随访时间为 15 个月(范围为 12-21 个月)。术前患者的腰痛 VAS 评分为 7.43(范围为 6-8),末次随访时为 0.86(范围为 0-2);术前腿痛 VAS 评分为 6.14(范围为 4-9),末次随访时为 0.71(范围为 0-1);术前 ODI 为 53.57%(范围为 38%-63%),末次随访时为 15.57%(范围为 5%-26%)。在 3 个月随访时,3 例患者可见椎间连续骨小梁桥接,其余 4 例在 6 个月随访时可识别出连续骨小梁桥接,达到了脊柱椎间融合的标准。末次随访时,根据改良 MacNab 标准,4 例患者评为优(4/7),3 例患者评为良(3/7)。

结论

本研究表明,经皮内镜椎间孔腰椎体间融合术可获得满意的治疗效果,即使对于不能耐受全身麻醉的患者也是如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/383e/6451828/af05059ce95b/BMRI2019-3091459.001.jpg

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