[1]童悦歆,孙 克,李鹏飞,等.腰椎经皮内镜减压结合非融合内固定治疗合并腰椎不稳的老年退行性腰椎管狭窄症的效果[J].医学信息,2021,34(19):123-126.[doi:10.3969/j.issn.1006-1959.2021.19.032]
　TONG Yue-xin,SUN Ke,LI Peng-fei,et al.Clinical Efficacy of Lumbar Percutaneous Endoscopic Decompression Combined with Non-fusion Internal Fixation in Elderly Patients with Degenerative Lumbar Spinal Stenosis Combinedwith Lumbar Instability[J].Medical Information,2021,34(19):123-126.[doi:10.3969/j.issn.1006-1959.2021.19.032]
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腰椎经皮内镜减压结合非融合内固定治疗合并腰椎不稳的老年退行性腰椎管狭窄症的效果()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年19期
页码:
123-126
栏目:
临床研究
出版日期:
2021-10-01

文章信息/Info

Title:
Clinical Efficacy of Lumbar Percutaneous Endoscopic Decompression Combined with Non-fusion Internal Fixation in Elderly Patients with Degenerative Lumbar Spinal Stenosis Combinedwith Lumbar Instability
文章编号:
1006-1959（2021）19-0123-04
作者:
童悦歆1; 2; 孙 克1; 2; 李鹏飞1; 2; 张哲哲1; 2; 宋有鑫2
1.承德医学院，河北 承德 067000；2.承德医学院附属医院微创脊柱外科，河北 承德 067000
Author(s):
TONG Yue-xin1; 2; SUN Ke1; 2; LI Peng-fei1; 2; ZHANG Zhe-zhe1; 2; SONG You-xin2
1.Chengde Medical University,Chengde 067000,Hebei,China;2.Department of Minimally Invasive Spine Surgery,Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei,China
关键词:
退行性腰椎管狭窄症; 经皮椎间孔镜减压术; 腰椎椎体间融合术
Keywords:
Degenerative lumbar spinal stenosis; Lumbar percutaneous endoscopic decompression; Lumbar interbody fusion
分类号:
R681.5
DOI:
10.3969/j.issn.1006-1959.2021.19.032
文献标志码:
A
摘要:
目的 探讨腰椎经皮内镜减压术联合经皮椎弓根螺钉固定术治疗合并腰椎不稳的老年退行性腰椎管狭窄症的效果。方法 选取2018年9月-2019年11月我院收治的63例合并腰椎不稳的老年退行性腰椎管狭窄症患者作为研究对象，根据手术方式不同分为对照组（n=30）和观察组（n=33）。对照组实施经椎间孔腰椎椎体间融合术治疗，观察组实施腰椎经皮内镜减压术联合经皮椎弓根螺钉固定术治疗，比较两组围手术期临床资料（手术时间、术中出血量、住院时间、术后卧床时间），术前、术后1天、3、6、12个月VAS、ODI、JOA评分及随访术后12个月不良反应发生情况。结果 观察组术中出血量、住院时间和术后卧床时间均小于对照组，差异有统计学意义（P＜0.05）；而两组手术时间比较，差异无统计学意义（P＞0.05）；观察组术后1天、3、6个月VAS、ODI、JOA评分优于对照组，差异有统计学意义（P＜0.05）；而两组术后12个月VAS、ODI、JOA评分比较，差异无统计学意义（P＞0.05）；观察组恶心、呕吐、贫血、脑梗死、切口相关并发症、嗜睡发生率低于对照组，差异有统计学意义（P＜0.05）。结论 腰椎经皮内镜减压联合经皮椎弓根螺钉固定术治疗合并腰椎不稳的老年退行性腰椎管狭窄症近期临床疗效优良，可有效缩短住院时间及术后卧床时间，减少术中出血量及围手术期不良事件，加速患者术后康复。
Abstract:
Objective To investigate the early clinical outcomes of percutaneous endoscopic lumbar decompression combined with percutaneous pedicle screw fixation in the treatment of elderly patients withdegenerative lumbar spinal stenosis with lumbar instability and to compare the clinical efficacy with that of transforaminal lumbar interbodyfusion.Methods A total of 63 elderly patients with degenerative lumbar spinal stenosis complicated with lumbar instability admitted to our hospital from September 2018 to November 2019 were selected as subjects. According to different surgical methods, they were divided into control group (n=30) and observation group (n=33). The control group was treated with transforaminal lumbar interbody fusion, and the observation group was treated with lumbar percutaneous endoscopic decompression combined with non-fusion internal fixation. The perioperative clinical data (operation time, intraoperative blood loss, hospitalization time, postoperative bed rest time), VAS, ODI, JOA scores before operation and 1 day, 3 months, 6 months and 12 months after operation, and the incidence of adverse reactions were compared between the two groups.Results The intraoperative blood loss, hospitalization time and postoperative bed time in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The VAS, ODI and JOA scores of the observation group at 1 day, 3 months and 6 months after operation were better than those of the control group, and the difference was statistically significant (P<0.05). The incidences of nausea, vomiting, anemia, cerebral infarction, incision-related complications and drowsiness in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05).Conclusion Lumbar percutaneous endoscopic decompression combined with percutaneous pedicle screw fixation has good short-term clinical efficacy in the treatment of senile degenerative lumbar spinal stenosis complicated with lumbar instability, which can effectively shorten the hospitalization time and postoperative bed time, reduce intraoperative blood loss and perioperative adverse events, and accelerate the recovery.

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更新日期/Last Update: 1900-01-01