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全内镜下中线椎间孔成形术:一种治疗腰椎椎间孔狭窄的替代方法。

Full-Endoscopic Midline Foraminoplasty: An Alternative Method for Treating Lumbar Foraminal Stenosis.

作者信息

Pairuchvej Saran, Keorochana Gun, Jitpakdee Khanathip, Rittipoldechs Chok-Anan, Kongthavornsakul Jatupon

机构信息

Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand.

Department of Orthopedic Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Neurospine. 2024 Dec;21(4):1172-1177. doi: 10.14245/ns.2448558.279. Epub 2024 Dec 31.

Abstract

OBJECTIVE

To describe the full-endoscopic lumbar foraminoplasty with midline skin incision (FEFM) and lateral recess decompression procedure and to report its clinical outcomes at the 1-year follow-up.

METHODS

Consecutive patients with lumbar foraminal and/or lateral recess stenosis who underwent FEFM procedures were retrospectively reviewed. Clinical outcomes were evaluated with a visual analogue scale (VAS) of back and leg pain and Oswestry Disability Index (ODI) up to 1 year postoperatively. The complications and recurrence rate were also recorded.

RESULTS

A total of 30 cases (51 levels) were included (L3-4, 6 cases [11.8%]; L4-5, 23 [45.1%]; L5-S1, 22 cases [43.1%]). VAS scores collected at preoperative, postoperative day 1, 3 months, 6 months, and 1 year were 9.16, 1.7, 1.36, 1.3, and 1.43, respectively. The ODI scores collected at preoperative, postoperative 3 months, 6 months, and 1 year were 46.63, 11.5, 10.66, and 10.46, respectively (p<0.05). The mean operation time was 88.7 minutes (range, 45-152 minutes). The length of hospital stay was 1.21 days (range, 1-3 days). No immediate complications were identified, and no patients experienced a recurrence of symptoms requiring revision surgery.

CONCLUSION

FEFM is an effective procedure for treating foraminal and/or lateral recess stenosis. It demonstrates the capability to decompress both bilateral foraminal and lateral recess stenosis through a single-entry point.

摘要

目的

描述经中线皮肤切口全内镜下腰椎椎间孔成形术(FEFM)及侧隐窝减压手术,并报告其1年随访的临床结果。

方法

回顾性分析连续接受FEFM手术的腰椎椎间孔和/或侧隐窝狭窄患者。采用视觉模拟评分法(VAS)评估腰腿痛情况,采用Oswestry功能障碍指数(ODI)评估术后1年内的功能障碍情况。记录并发症和复发率。

结果

共纳入30例患者(51个节段)(L3-4,6例[11.8%];L4-5,23例[45.1%];L5-S1,22例[43.1%])。术前、术后第1天、3个月、6个月和1年收集的VAS评分分别为9.16、1.7、1.36、1.3和1.43。术前、术后3个月、6个月和1年收集的ODI评分分别为46.63、11.5、10.66和10.46(p<0.05)。平均手术时间为88.7分钟(范围45-152分钟)。住院时间为1.21天(范围1-3天)。未发现即刻并发症,无患者出现症状复发需要翻修手术。

结论

FEFM是治疗椎间孔和/或侧隐窝狭窄的有效方法。它显示了通过单一入路点对双侧椎间孔和侧隐窝狭窄进行减压的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6b2/11744526/08262ea09eeb/ns-2448558-279f1.jpg

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