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经皮椎间孔镜下椎间盘切除术治疗腰椎管狭窄症合并骨质疏松症的疗效及安全性

Efficacy and safety of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar spinal stenosis combined with osteoporosis.

作者信息

Gu Xiaobin, Zhu Wenhui, He Haiyi, Wang Zili, Ding Shaolong, Guo Gaosheng

机构信息

Department of Orthopedics, Sanmenxia Central Hospital, Sanmenxia 472000, China.

出版信息

Rev Assoc Med Bras (1992). 2019 Jul 22;65(6):779-785. doi: 10.1590/1806-9282.65.6.779.

Abstract

OBJECTIVE

To investigate the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar spinal stenosis (LSS) combined with osteoporosis.

METHODS

Eighty patients with LSS combined with osteoporosis were divided into a control and PTED group, which received conventional transforaminal lumbar interbody fusion and PTED, respectively. The surgical indications, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores, bone mineral density (BMD), and adverse reactions were observed.

RESULTS

Compared with the control group, in the PTED group, the operation time, bleeding loss and hospitalization duration, incision VAS scores at postoperative 12, 24 and 48 h and lumbar and leg pain VAS and lumbar ODI scores on postoperative 6 months were significantly decreased (P < 0.01), and the lumbar JOA score on postoperative 6 months was significantly increased (P < 0.05). There was no significant difference in BMD between two groups (P > 0.05). Compared with the control group, in the PTED group, the total effective rate was significantly higher (P < 0.05), and the incidence of adverse reactions was significantly lower (P < 0.05).

CONCLUSIONS

PTED is safe and effective in the treatment of LSS combined with osteoporosis.

摘要

目的

探讨经皮椎间孔镜下椎间盘切除术(PTED)治疗腰椎管狭窄症(LSS)合并骨质疏松症的疗效及安全性。

方法

将80例LSS合并骨质疏松症患者分为对照组和PTED组,分别接受传统经椎间孔腰椎椎间融合术和PTED。观察手术适应证、切口视觉模拟评分(VAS)、腰腿痛VAS、腰椎日本骨科协会(JOA)和Oswestry功能障碍指数(ODI)评分、骨密度(BMD)及不良反应。

结果

与对照组相比,PTED组手术时间、失血量及住院时间、术后12、24和48小时切口VAS评分以及术后6个月腰腿痛VAS和腰椎ODI评分均显著降低(P < 0.01),术后6个月腰椎JOA评分显著升高(P < 0.05)。两组BMD差异无统计学意义(P > 0.05)。与对照组相比,PTED组总有效率显著更高(P < 0.05),不良反应发生率显著更低(P < 0.05)。

结论

PTED治疗LSS合并骨质疏松症安全有效。

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