Li Chi, Guo Zhonghua
Department of Orthopedics, People's Hospital of Dongxihu District Wuhan City, Wuhan, Hubei 430040, China.
Evid Based Complement Alternat Med. 2022 Sep 26;2022:9040402. doi: 10.1155/2022/9040402. eCollection 2022.
To investigate the efficacy of percutaneous transforaminal endoscopic lumbar decompression (PTED) in the treatment of multisegment lumbar spinal stenosis (LSS) and its effect on VAS scores.
126 patients with multisegment LSS admitted between August 2017 and August 2021 were selected and divided into the PTED group and the traditional open surgery group (TOS group) according to the different treatment methods. There were 70 cases in the PTED group, treated with PTED, and 56 cases in the TOS group, treated with traditional open surgery. The clinical outcomes, the preoperative and postoperative pain visual analogue scale (VAS), the Oswestry disability index (ODI), the SF-36 quality of life questionnaire scores, the perioperative indicators (operative time, days in hospital, intraoperative blood loss), the postoperative complications, and imaging data were compared between the two groups.
After the operation, the excellent and good rate in the PTED group (91.43%) was significantly higher than that in the TOS group (75.00%) ( < 0.05). At each time after the operation, the VAS and ODI scores of the two groups were lower than those before the operation, and the VAS scores of the PTED group at 1 day and 3 months after operation were lower than those of the TOS group, and the ODI scores of the PTED group at 3 months after operation were lower than those of the TOS group ( < 0.05). 3 months after the operation, the SF-36 scores in both groups were higher than those before the operation, and those in the PTED group were higher than those in the TOS group ( < 0.05). The operation time and days in hospital in the PTED group were shorter than those in the TOS group, and the intraoperative dominant blood loss and recessive blood loss were less than those in the TOS group ( < 0.05). The total incidence of complications in the PTED group (15.71%) was significantly lower than that in the TOS group (32.14%) ( < 0.05).
Both PTED and traditional open surgery are effective in treating patients with multisegmental LSS, and both show positive postoperative changes in all indicators, but the former has more promising near -term results in improving lumbar spine pain, function and quality of life than the latter, and has the advantages of less trauma, less bleeding, and fewer complications.
探讨经皮椎间孔镜腰椎减压术（PTED）治疗多节段腰椎管狭窄症（LSS）的疗效及其对视觉模拟评分（VAS）的影响。
选取2017年8月至2021年8月收治的126例多节段LSS患者，根据治疗方法不同分为PTED组和传统开放手术组（TOS组）。PTED组70例，采用PTED治疗；TOS组56例，采用传统开放手术治疗。比较两组的临床疗效、术前及术后疼痛视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）、SF-36生活质量问卷评分、围手术期指标（手术时间、住院天数、术中出血量）、术后并发症及影像学资料。
术后，PTED组优良率（91.43%）显著高于TOS组（75.00%）（P<0.05）。术后各时间点，两组的VAS和ODI评分均低于术前，且PTED组术后1天和3个月的VAS评分低于TOS组，PTED组术后3个月的ODI评分低于TOS组（P<0.05）。术后3个月，两组的SF-36评分均高于术前，且PTED组高于TOS组（P<0.05）。PTED组的手术时间和住院天数短于TOS组，术中显性出血量和隐性出血量少于TOS组（P<0.05）。PTED组并发症总发生率（15.71%）显著低于TOS组（32.14%）（P<0.05）。
PTED和传统开放手术治疗多节段LSS患者均有效，且术后各项指标均呈阳性变化，但前者在改善腰椎疼痛、功能及生活质量方面的近期效果优于后者，具有创伤小、出血少、并发症少的优点。
