Department of Orthopedic Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, People's Republic of China.
NHC Key Laboratory of Cell Transplantation, Harbin Medical University, Harbin, People's Republic of China.
Clin Interv Aging. 2023 Jun 7;18:911-919. doi: 10.2147/CIA.S414559. eCollection 2023.
The number of patients with lumbar spinal stenosis (LSS) with degenerative lumbar scoliosis (DLS) is gradually increasing as the population ages. The purpose of this study was to evaluate the clinical outcomes of 10-mm endoscopic minimally invasive interlaminar decompression for LSS with DLS and simple LSS.
The clinical data of 175 consecutive elderly patients with LSS were retrospectively analyzed. They were divided into LSS group and LSS with DLS group based on whether they were accompanied by DLS. Patient demographics, perioperative indicators, and clinical outcomes were recorded. Lumbar spine stability was assessed by imaging data. Meanwhile, visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and the modified Macnab criteria were used to assess clinical outcomes.
There were 129 patients in the LSS group and 46 patients in the LSS with DLS group. Both groups had similar VAS and ODI scores preoperatively, and both were significantly lower postoperatively (P < 0.05). However, patients combined with DLS showed higher VAS scores for low back pain at 3 months and 1 year postoperatively (P < 0.05). In addition, postoperative LL and PI-LL were significantly improved in both groups (P < 0.05). However, patients in LSS with DLS group showed higher PT, PI and PI-LL before and after surgery. According to the modified Macnab criteria, the excellent and good rates were 92.25% and 89.13% in the LSS group and LSS with DLS group at the last follow-up, respectively.
10-mm endoscopic minimally invasive interlaminar decompression for LSS with or without DLS has shown satisfactory clinical outcomes. However, patients with DLS may have higher residual low back pain after surgery.
随着人口老龄化,腰椎管狭窄症(LSS)伴退变性腰椎侧凸(DLS)患者的数量逐渐增加。本研究旨在评估 10mm 内镜微创椎板间减压术治疗伴或不伴 DLS 的 LSS 以及单纯 LSS 的临床疗效。
回顾性分析 175 例老年 LSS 患者的临床资料,根据是否伴有 DLS 将其分为 LSS 组和 LSS 伴 DLS 组。记录患者的人口统计学、围手术期指标和临床疗效。通过影像学资料评估腰椎稳定性。同时,采用视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)评分和改良 Macnab 标准评估临床疗效。
LSS 组 129 例,LSS 伴 DLS 组 46 例。两组患者术前 VAS 和 ODI 评分相似,术后均明显降低(P<0.05)。但合并 DLS 的患者术后 3 个月和 1 年腰痛 VAS 评分较高(P<0.05)。此外,两组术后 LL 和 PI-LL 均明显改善(P<0.05)。但 LSS 伴 DLS 组患者术前、术后 PT、PI 和 PI-LL 较高。根据改良 Macnab 标准,LSS 组和 LSS 伴 DLS 组末次随访时优良率分别为 92.25%和 89.13%。
10mm 内镜微创椎板间减压术治疗伴或不伴 DLS 的 LSS 临床疗效满意,但合并 DLS 的患者术后腰痛残留可能较高。