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经骶骨硬膜外内窥镜激光减压术对腰椎间盘突出症患者生活质量的影响。

The impact of trans-sacral epiduroscopic laser decompression on quality of life in lumbar disc herniation.

机构信息

Department of Anesthesiology and Reanimation, Fırat University Faculty of Medicine, Elazığ, Türkiye.

Department of Pain Management, Ankara Training and Research Hospital, Ankara, Türkiye.

出版信息

Agri. 2024 Jan;36(4):218-226. doi: 10.14744/agri.2023.75983.

Abstract

OBJECTIVES

Trans-sacral epiduroscopic laser decompression (SELD), employing a video-guided catheter and laser, is one of the preferred options for minimally invasive treatment in lumbar disc disease. The aim of this study was to evaluate the effect of SELD treatment on pain, disability, and quality of life in patients with lumbar disc herniation.

METHODS

Between January 2015 and June 2017, a total of 76 patients who underwent SELD were examined retrospectively. The Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores were recorded preoperatively, as well as 1, 3, 6, and 12 months after SELD. Quality of life was recorded preoperatively and 12 months after SELD. Patient satisfaction was evaluated based on Odom's Criteria at the final follow-up.

RESULTS

Improvement was observed in low back pain and radicular pain, with the VAS score decreasing from 6.5±0.9 and 7.2±0.3 to 2.31±1.6 and 2.9±1.3 at the final follow-up (p<0.001). The rate of disability, assessed by ODI, decreased from 65.21±1.7 to 21.38±1.0 at the final follow-up. SF-36 scores were statistically higher for all sub-variables of the questionnaire after the procedure. At the final follow-up, 65.8% of patients reported a degree of satisfaction as excellent-good based on Odom's Criteria.

CONCLUSION

Trans-sacral epiduroscopic laser decompression enhances quality of life by improving pain and disability scores in patients with chronic low back and/or radicular pain who do not respond to conservative treatments and epidural steroid administration.

摘要

目的

经骶骨硬膜外内窥镜激光减压术(SELD)采用视频引导导管和激光,是腰椎间盘疾病微创治疗的首选方法之一。本研究旨在评估 SELD 治疗对腰椎间盘突出症患者疼痛、残疾和生活质量的影响。

方法

回顾性分析 2015 年 1 月至 2017 年 6 月期间 76 例行 SELD 治疗的患者。记录术前、术后 1、3、6 和 12 个月的 Oswestry 功能障碍指数(ODI)和视觉模拟量表(VAS)评分。记录术前和术后 12 个月的生活质量。末次随访时根据 Odom 标准评估患者满意度。

结果

术后腰痛和神经根痛均有改善,VAS 评分从术前的 6.5±0.9 和 7.2±0.3 降至末次随访时的 2.31±1.6 和 2.9±1.3(p<0.001)。ODI 评估的残疾率从术前的 65.21±1.7 降至末次随访时的 21.38±1.0。术后问卷的所有亚变量的 SF-36 评分均有统计学意义提高。末次随访时,65.8%的患者根据 Odom 标准报告满意度为优-良。

结论

经骶骨硬膜外内窥镜激光减压术通过改善对保守治疗和硬膜外类固醇注射无效的慢性腰痛和/或神经根痛患者的疼痛和残疾评分,提高生活质量。

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