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内镜下脊柱减压术:某学术医学中心疼痛结局的回顾性研究

Endoscopic Spinal Decompression: A Retrospective Review of Pain Outcomes at an Academic Medical Center.

作者信息

Panjeton Geoffrey D, Brown Holden L, Searcy Sam, Meroney Matthew, Kumar Sanjeev

机构信息

Anesthesiology, University of Florida College of Medicine, Gainesville, USA.

出版信息

Cureus. 2021 Oct 29;13(10):e19112. doi: 10.7759/cureus.19112. eCollection 2021 Oct.

Abstract

INTRODUCTION

Spinal stenosis is a chronic, debilitating condition that is expected to affect an increasing number of people as the population ages. Symptomatic spinal stenosis, like other spine pathologies, including disc herniation and degenerative disc disease, traditionally required an open decompressive surgical approach if more conservative approaches failed. An emerging alternative has been developed to address the needs of this population of patients in the form of endoscopic spine surgery (ESS). Advantages of ESS include minimal tissue trauma, decreased risk of damage to the neurovascular structures, minimal epidural fibrosis/scarring, reduced hospital stay, early functional recovery, and improved cosmetic outcomes. The purpose of this study was to review the outcomes of patients undergoing transforaminal endoscopic spinal decompression at an academic pain program.

METHODS

We conducted a retrospective review of electronic medical records with approval from the University of Florida Institutional Review Board (IRB #202001529). Twenty patients underwent successful transforaminal endoscopic lumbar spinal decompression surgery at UF Health Pain Medicine from July 1, 2019, to June 1, 2020. The majority of cases were performed at L4-5 (n = 14), followed by an equal number (n = 3) of cases at L3-4 and L5-S1. Preoperative and postoperative visual analog scale (VAS) pain scores from patients' pain clinic appointments were obtained from the electronic health records system to assess the intervention as a pain relief strategy.

RESULTS

Patients had an average pain reduction of 82% (SD = 31%), resulting in an average postoperative pain score of 1.8 (SD = 2.8) on a 10-point VAS.

CONCLUSION

This study highlights the benefits of endoscopic spine surgery for patients, including pain reduction and reduced scarring.

摘要

引言

椎管狭窄是一种慢性致残性疾病,随着人口老龄化,预计受影响的人数会不断增加。与其他脊柱疾病(包括椎间盘突出症和椎间盘退变疾病)一样,有症状的椎管狭窄如果更保守的治疗方法失败,传统上需要采用开放性减压手术。一种新兴的替代方法已经出现,以内镜脊柱手术(ESS)的形式满足这类患者的需求。ESS的优点包括组织创伤最小、神经血管结构受损风险降低、硬膜外纤维化/瘢痕形成最小、住院时间缩短、功能恢复早以及美容效果改善。本研究的目的是回顾在一个学术性疼痛治疗项目中接受经椎间孔内镜下脊柱减压患者的治疗结果。

方法

我们在获得佛罗里达大学机构审查委员会(IRB #202001529)批准后,对电子病历进行了回顾性研究。2019年7月1日至2020年6月1日期间,20例患者在佛罗里达大学健康疼痛医学中心成功接受了经椎间孔内镜下腰椎减压手术。大多数病例在L4 - 5节段进行(n = 14),其次是L3 - 4和L5 - S1节段,各有3例。从电子健康记录系统中获取患者疼痛门诊预约时术前和术后的视觉模拟量表(VAS)疼痛评分,以评估该干预措施作为一种疼痛缓解策略的效果。

结果

患者平均疼痛减轻了82%(标准差 = 31%),在10分制的VAS上,术后平均疼痛评分为1.8(标准差 = 2.8)。

结论

本研究突出了内镜脊柱手术对患者的益处,包括减轻疼痛和减少瘢痕形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bcb/8614167/d875eab478ea/cureus-0013-00000019112-i01.jpg

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