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椎板切除术减压与经皮椎间孔镜手术对老年腰椎管狭窄症患者术后伤口愈合、疼痛强度及腰椎功能的影响

Influence of decompression by laminotomy and percutaneous tansforaminal endoscopic surgery on postoperative wound healing, pain intensity, and lumbar function in elderly patients with lumbar spinal stenosis.

作者信息

Zhu Haiyang, Liu Yuan, Wang Yijing, Xu Denghui, Zhao Zhe, Wu Xuejian

机构信息

Emergency Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Imaging and Nuclear Medicine Ward, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Ann Med. 2025 Dec;57(1):2472865. doi: 10.1080/07853890.2025.2472865. Epub 2025 Mar 3.

DOI:10.1080/07853890.2025.2472865
PMID:40033779
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11881652/
Abstract

PURPOSE

To compare the wound healing, pain intensity and lumbar function in elderly patients with lumbar spinal stenosis after laminectomy decompression or percutaneous transforaminal endoscopic surgery.

METHODS

A retrospective study was conducted on 65 patients who underwent laminotomy and 69 patients who underwent percutaneous transforaminal endoscopic spinal decompression surgery. clinical data analysis, including surgical parameters, complications, postoperative wound healing, pain intensity, lumbar function, and correlation analysis, was performed.

RESULTS

The operative time of percutaneous transforaminal endoscopic surgery was significantly shorter than that of laminotomy (70.78±6.80 min vs 128.97±4.70 min, < 0.001), intraoperative blood loss was significantly reduced (94.22± 7.69ml vs 327.68± 6.44ml, < 0.001), postoperative wound healing time and time to get out of bed were significantly shortened, pain was reduced by visual analog scale (3.48±1.11 vs 2.80±1.05, = 0.007), the Japanese Orthopaedic Association (JOA) score was significantly increased, and the Oswestry Disability Index (ODI) score showed significantly decrease. The incidence of urinary tract infection and urinary retention was higher after laminotomy. Correlation analysis showed that operative time, intraoperative blood loss, and time to get out of bed were significantly related to prognosis in elderly patients.

CONCLUSION

Percutaneous transforaminal endoscopic surgery is significantly superior to conventional laminectomy decompression in the treatment of elderly lumbar spinal stenosis.

摘要

目的

比较老年腰椎管狭窄症患者行椎板切除减压术或经皮椎间孔镜手术后的伤口愈合情况、疼痛强度及腰椎功能。

方法

对65例行椎板切开术的患者和69例行经皮椎间孔镜下脊柱减压手术的患者进行回顾性研究。进行临床数据分析,包括手术参数、并发症、术后伤口愈合情况、疼痛强度、腰椎功能及相关性分析。

结果

经皮椎间孔镜手术的手术时间明显短于椎板切开术(70.78±6.80分钟对128.97±4.70分钟,<0.001),术中出血量明显减少(94.22±7.69毫升对327.68±6.44毫升,<0.001),术后伤口愈合时间和下床时间明显缩短,视觉模拟评分法显示疼痛减轻(3.48±1.11对2.80±1.05,=0.007),日本骨科学会(JOA)评分明显提高,奥斯威斯利功能障碍指数(ODI)评分明显降低。椎板切开术后尿路感染和尿潴留的发生率较高。相关性分析表明,手术时间、术中出血量和下床时间与老年患者的预后显著相关。

结论

在老年腰椎管狭窄症的治疗中,经皮椎间孔镜手术明显优于传统的椎板切除减压术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e89/11881652/6c089a6da1b6/IANN_A_2472865_F0001_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e89/11881652/6c089a6da1b6/IANN_A_2472865_F0001_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e89/11881652/6c089a6da1b6/IANN_A_2472865_F0001_C.jpg

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本文引用的文献

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Perspective: Efficacy and outcomes for different lumbar interspinous devices (ISD) vs. open surgery to treat lumbar spinal stenosis (LSS).
观点:不同腰椎棘突间装置(ISD)与开放手术治疗腰椎管狭窄症(LSS)的疗效及结果对比
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