Tong H Y, Yu X G, Wang Q, Zhao B, Bai S C
Department of Neurosurgery, First Center of PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 4;100(4):261-264. doi: 10.3760/cma.j.issn.0376-2491.2020.04.004.
To analysis of the efficacy of tubular paraspinal approach and conventional semi-laminar approach in treating lumbar stenosis. Retrospective research of clinical data of 56 lumbar stenosis cases who were operated in neurosurgery department of first center of PLA general hospital from May 2015 to June 2018. Collecting the information of sex, age, operating time, intraoperative blood loss, postoperative duration in bed, as well as length of hospital stay of those patients. The 2 groups of cases, tubular paraspinal approach group (35)and semi-laminal approachgroup (21), compared by Japanese orthopedic association (JOA) score and visual analogue scale to assess the functional situation of the patients before operation, 1 week after operation, 1 month after operation, 6 months after operation, and the last follow up. The operating time(83.1±7.3 vs 86.1±9.6 min), intraoperative blood loss(18.2±3.9 vs 40.5±13.3 ml), postoperative duration in bed(37.4±7.8 vs 63.7±15.8 h), as well as length of hospital stay (3.8±1.1 vs 6.5±2.0 d)were all obviously better in tubular paraspinal approach group than in traditional semi-laminar approach group(0.05). The postoperative 1 week, 1month, and 6 months JOA score (21.8±3.4, 23.6±2.4, 24.2±2.4 vs 19.9±3.7, 21.6±2.8, 22.4±2.1)and VAS (2.2±1.0, 2.0±1.1, 0.4±0.1 vs 3.1±1.2, 2.6±1.3, 0.5±0.1) were better in tubular paraspinal approach group than semi-laminar approach group (0.05). While at the last follow up, the JOA score and VAS were similar in the 2 groups (0.05) . In non-fusion techniques for treating lumbar stenosis, tubular paraspinal approach demonstrated less blood loss, shorter stay in bed as well as in hospital, and better symptom relief in early postoperative period than traditional semi-laminal approach. While at long term follow up, both approaches achieved satisfactory outcome.
分析管状椎旁入路与传统半椎板入路治疗腰椎管狭窄症的疗效。回顾性研究2015年5月至2018年6月在中国人民解放军总医院第一医学中心神经外科接受手术的56例腰椎管狭窄症患者的临床资料。收集患者的性别、年龄、手术时间、术中出血量、术后卧床时间以及住院时间等信息。将病例分为2组，管状椎旁入路组（35例）和半椎板入路组（21例），采用日本骨科协会（JOA）评分和视觉模拟量表评估患者术前、术后1周、术后1个月、术后6个月以及末次随访时的功能状况。管状椎旁入路组的手术时间（83.1±7.3 vs 86.1±9.6分钟）、术中出血量（18.2±3.9 vs 40.5±13.3毫升）、术后卧床时间（37.4±7.8 vs 63.7±15.8小时）以及住院时间（3.8±1.1 vs 6.5±2.0天）均明显优于传统半椎板入路组（P<0.05）。管状椎旁入路组术后1周、1个月和6个月的JOA评分（21.8±3.4、23.6±2.4、24.2±2.4 vs 19.9±3.7、21.6±2.8、22.4±2.1）和VAS评分（2.2±1.0、2.0±1.1、0.4±0.1 vs 3.1±1.2、2.6±1.3、0.5±0.1）均优于半椎板入路组（P<0.05）。而在末次随访时，两组的JOA评分和VAS评分相似（P>0.05）。在治疗腰椎管狭窄症的非融合技术中，管状椎旁入路比传统半椎板入路术中出血更少、卧床及住院时间更短，术后早期症状缓解更好。而在长期随访中，两种入路均取得了满意的效果。
