Jain Sameer, Deer Timothy, Sayed Dawood, Chopra Pooja, Wahezi Sayed, Jassal Navdeep, Weisbein Jackie, Jameson Jessica, Malinowski Mark, Golovac Stanley
Pain Treatment Centers of America, Little Rock, AR 72211, USA.
The Spine & Nerve Center of The Virginias, Charleston, WV 25301, USA.
Pain Manag. 2020 Sep;10(5):331-348. doi: 10.2217/pmt-2020-0037. Epub 2020 Jul 1.
Lumbar spinal stenosis is a common degenerative spine condition. In properly selected patients, minimally invasive lumbar decompression () may be an option to improve outcomes. This review provides an in-depth description of the procedure and a comprehensive examination of safety and efficacy. Two randomized controlled trials, together with 11 other controlled clinical studies, have established the efficacy of , which is a minimally invasive procedure that does not involve implants and has demonstrated excellent efficacy and safety. With an established safety profile equivalent to epidural steroid injections, and efficacy that has been shown to be superior to such injections, can reasonably be positioned early in the treatment algorithm for these patients. Based on extensive review of the literature, robust safety and efficacy through 2 years, and in accordance with minimally invasive spine treatment guidelines, is recommended as the first intervention after failure of conservative measures for lumbar spinal stenosis patients with neurogenic claudication and ligamentum flavum hypertrophy.
腰椎管狭窄症是一种常见的脊柱退行性疾病。对于经过适当选择的患者，微创腰椎减压术可能是改善治疗效果的一种选择。本综述对该手术进行了深入描述，并对其安全性和有效性进行了全面审查。两项随机对照试验以及其他11项对照临床研究证实了该手术的有效性，该手术是一种不涉及植入物的微创手术，已证明具有出色的有效性和安全性。鉴于其已确立的安全性与硬膜外类固醇注射相当，且有效性已被证明优于此类注射，因此在这些患者的治疗方案中，该手术可合理地排在早期。基于对文献的广泛回顾、长达两年的可靠安全性和有效性，以及符合微创脊柱治疗指南，对于患有神经源性间歇性跛行和黄韧带肥厚的腰椎管狭窄症患者，在保守治疗失败后，建议将该手术作为首选干预措施。
