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经皮双侧内镜下腰椎椎间融合术:技术说明及初步结果

Percutaneous Bilateral Endoscopic Lumbar Interbody Fusion: Technical Note and Preliminary Results.

作者信息

Chen Huan, Zhang Huan, Yang Erping, Ling Qinjie, He Erxing

机构信息

Spine Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Department of Orthopedics, Huanggang Central Hospital of Yangtze University, Hubei, China.

出版信息

Biomed Res Int. 2022 Apr 11;2022:2227679. doi: 10.1155/2022/2227679. eCollection 2022.

Abstract

OBJECTIVE

The purpose of this study was to investigate the feasibility and clinical efficacy of the percutaneous bilateral endoscopy technique (microendoscopic trans-Kambin's triangle lumbar interbody fusion + percutaneous endoscopic transforaminal decompression of the lumbar spinal canal, ME-TKT-LIF+ PETD) in the treatment of lumbar degenerative diseases.

METHODS

From May 2016 to September 2018, 29 patients (16 males and 13 females) who suffered from neurologic symptoms due to degenerative lumbar spine disease and underwent percutaneous bilateral endoscopy technique were enrolled. A microendoscope was used for fusion, and a percutaneous endoscope was used for spinal canal decompression. These patients' perioperative and clinical outcome-related parameters were collected and analyzed.

RESULTS

The mean intraoperative blood loss was 72.8 ± 40.6 ml, the operation time was 87.1 ± 10.1 min, the postoperative ambulatory time was 1.69 ± 1.0 days, the hospital stay was 2.6 ± 1.3 days, and the follow-up period was 22.34 ± 4.2 months. The visual analog scale (VAS) and the Oswestry disability index (ODI) were significantly improved at the early postoperative and last follow-up, respectively. According to the modified MacNab criteria, 11 (11/29) cases were rated as excellent, 15 (15/29) as good, and 3 (3/29) as fair, and the excellent and good rate was 89.7%. Twenty-eight (28/29) cases demonstrated solid fusion, and the fusion rate was 96.6%.

CONCLUSION

The percutaneous bilateral endoscopy technique is safe and feasible in the treatment of lumbar degenerative diseases, with the advantage that more normal anatomical structures are preserved. It is an optional method of lumbar interbody fusion.

摘要

目的

本研究旨在探讨经皮双侧内镜技术(显微内镜经坎宾三角腰椎椎间融合术+经皮内镜下腰椎管椎间孔减压术,ME-TKT-LIF+PETD)治疗腰椎退行性疾病的可行性及临床疗效。

方法

选取2016年5月至2018年9月因腰椎退行性疾病出现神经症状并接受经皮双侧内镜技术治疗的29例患者(男16例,女13例)。采用微型内镜进行融合,经皮内镜进行椎管减压。收集并分析这些患者围手术期及临床结局相关参数。

结果

术中平均出血量为72.8±40.6ml,手术时间为87.1±10.1分钟,术后下床活动时间为1.69±1.0天,住院时间为2.6±1.3天,随访时间为22.34±4.2个月。术后早期和末次随访时视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)均显著改善。根据改良MacNab标准,优11例(11/29),良15例(15/29),可3例(3/29),优良率为89.7%。28例(28/29)实现坚固融合,融合率为96.6%。

结论

经皮双侧内镜技术治疗腰椎退行性疾病安全可行,具有保留更多正常解剖结构的优势,是腰椎椎间融合的一种可选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f6/9015859/ebf5f1a6a24e/BMRI2022-2227679.001.jpg

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