Yan Zhi-Gang, Wang Yuan-Li, Shi Jian-Feng, Yang Li-Li, Liu Zhuang
Department of Orthopaedics, Beijing Longfu Hospital, Beijing 100010, China.
Zhongguo Gu Shang. 2021 Mar 25;34(3):249-54. doi: 10.12200/j.issn.1003-0034.2021.03.012.
To observe the clinical effect of transforaminal endoscopy combined with interspinous fusion in the treatment of lumbar spinal stenosis with instability in the elderly.
From February 2018 to February 2019, 82 elderly patients with lumbar spinal stenosis and instability were divided into control group and observation group. In the control group, there were 23 males and 18 females;the age was (68.9±4.1) years;the course of disease was (14.1±5.7) months;there were 5 cases of single segment lesions and 36 cases of multi segment lesions;simple bacfuse interspinous fusion was used. In the observation group, there were 22 males and 19 females;the age was (69.1±4.0) years;the course of diseasewas (14.4±5.5) months;there were 6 cases of single segment lesions and 35 cases of multi segment lesions;they were treated with transforaminal endoscopic surgery combined with Bacfuse interspinous fusion. The clinical efficacy, visual analogue scale (VAS), Japanese Orthopaedic Association scores (JOA), Oswestry disability index (ODI), Lehmann lumbar function score, posterior disc height and intervertebral foramen height, complication rate and recurrence rate of the two groups were compared.
The clinical efficacy of the observation group was better than that of the control group;the VAS score of the observation group was lower than that of the control group, the JOA score was higher than that of the control group, and the ODI index at 3 months after operation and at the last follow-up was lower than that of the control group, the Lehmann lumbar function score was higher than that of the control group;the posterior edge height of intervertebral disc and intervertebral foramen height were higher than those of the controlgroup;the incidence of complications and recurrence rate (4.9% and 0.0%) of the observation group were lower than those of the control group (19.5%, 9.8%), the difference was statistically significant (<0.05).
The clinical effect of transforaminal endoscopy combined with interspinous process fusion in the treatment of lumbar spinal stenosis with instability in the elderly is ideal. It can reduce postoperative pain, improve lumbar function, improve the height of posterior edge of intervertebral disc and intervertebral foramen, and reduce the incidence and recurrence rate. It is worthy of clinical promotion.
观察经椎间孔镜联合棘突间融合术治疗老年腰椎管狭窄症伴腰椎不稳的临床疗效。
选取2018年2月至2019年2月收治的82例老年腰椎管狭窄症伴腰椎不稳患者，分为对照组和观察组。对照组男23例，女18例；年龄（68.9±4.1）岁；病程（14.1±5.7）个月；单节段病变5例，多节段病变36例；采用单纯棘突间融合术。观察组男22例，女19例；年龄（69.1±4.0）岁；病程（14.4±5.5）个月；单节段病变6例，多节段病变35例；采用经椎间孔镜手术联合棘突间融合术。比较两组的临床疗效、视觉模拟评分法（VAS）、日本骨科学会评分（JOA）、Oswestry功能障碍指数（ODI）、Lehmann腰椎功能评分、椎间盘后缘高度及椎间孔高度、并发症发生率及复发率。
观察组临床疗效优于对照组；观察组VAS评分低于对照组，JOA评分高于对照组，术后3个月及末次随访时ODI指数低于对照组，Lehmann腰椎功能评分高于对照组；椎间盘后缘高度及椎间孔高度高于对照组；观察组并发症发生率及复发率（4.9%和0.0%）低于对照组（19.5%，9.8%），差异有统计学意义（<0.05）。
经椎间孔镜联合棘突间融合术治疗老年腰椎管狭窄症伴腰椎不稳临床效果理想，可减轻术后疼痛，改善腰椎功能，提高椎间盘后缘高度及椎间孔高度，降低并发症发生率及复发率，值得临床推广。
