[1]高正添,贾天阳,常成兵,等.椎间孔镜治疗退行性腰椎管狭窄症疗效分析及术后复发因素分析[J].医学信息,2019,32(01):115-118.[doi:10.3969/j.issn.1006-1959.2019.01.035]
　GAO Zheng-tian,JIA Tian-yang,CHANG Cheng-bing,et al.Analysis of the Efficacy of Intervertebral Foramen in the Treatment of Degenerative Lumbar Spinal Stenosis and Analysis of Postoperative Recurrence Factors[J].Journal of Medical Information,2019,32(01):115-118.[doi:10.3969/j.issn.1006-1959.2019.01.035]
点击复制

椎间孔镜治疗退行性腰椎管狭窄症疗效分析及术后复发因素分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年01期
页码:
115-118
栏目:
临床研究
出版日期:
2019-01-01

文章信息/Info

Title:
Analysis of the Efficacy of Intervertebral Foramen in the Treatment of Degenerative Lumbar Spinal Stenosis and Analysis of Postoperative Recurrence Factors
文章编号:
1006-1959（2019）01-0115-04
作者:
高正添; 贾天阳; 常成兵; 陈 宾
承德医学院附属医院脊柱外二科，河北 承德 067000
Author(s):
GAO Zheng-tian; JIA Tian-yang; CHANG Cheng-bing; CHEN Bin
Department of Spinal Surgery,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China
关键词:
椎间孔镜; 复发; 危险因素; 腰椎管狭窄
Keywords:
Intervertebral foramen; Recurrence; Risk factors; Lumbar spinal stenosis
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2019.01.035
文献标志码:
A
摘要:
目的 分析经皮椎间孔镜治疗退行性腰椎管狭窄症疗效并统计术后复发病例，分析其发生原因，并归纳相关危险因素。方法 选取我科经皮椎间孔镜治疗退行性腰椎管狭窄症手术共188例进行为期1年的随访，分析手术疗效并对复发病例行二次椎间孔镜治疗，探讨术后复发原因，归纳相关危险因素。结果 本组术后评分改善明显，术后1年优良率为88.83%；术后共出现复发患者6例，占总数3.19%，复发原因为术中髓核摘除不彻底、术中定位不佳、术前合并终板炎、术后活动过多等；均经二次PELD治疗逐渐康复，术后1年改良MacNab疗效评定4例优，1例良，1例可；术前合并终板炎9例，其中3例复发。结论 经皮椎间孔镜治疗退行性腰椎管狭窄症的短期疗效确切，安全性高，术前合并终板炎可能为影响术后复发的高危因素，术前严格掌握手术适应证、把控相关危险因素、提高手术技巧可降低术后复发率。
Abstract:
Objective To analyze the efficacy of percutaneous transforaminal lumbar stenosis in the treatment of degenerative lumbar spinal stenosis and to analyze the recurrence cases, and to analyze the causes and summarize the related risk factors. Methods A total of 188 patients with degenerative lumbar spinal stenosis underwent percutaneous transluminal angioplasty for one-year follow-up. The curative effect was analyzed and the patients with recurrent cases were treated with secondary intervertebral foramen. Induction of relevant risk factors. Results The postoperative scores of this group improved significantly. The excellent and good rate was 88.83% after 1 year. There were 6 cases of recurrence after operation, accounting for 3.19% of the total. The recurrence was due to incomplete nucleus pulposus removal and poor intraoperative positioning. Preoperative combined endplate inflammation, excessive postoperative activities, etc.; all gradually recovered by secondary PELD treatment, 4 cases of improved MacNab efficacy after 1 year of surgery, 1 case is good, 1 case was available; 9 cases of endplate inflammation were combined before operation, and 3 cases recurred. Conclusion The short-term curative effect of percutaneous transforaminal lumbar stenosis for degenerative lumbar spinal stenosis is safe and high. Preoperative combined endplate inflammation may be a risk factor for postoperative recurrence. Surgical indications and control are strictly controlled before operation. Risk factors and improved surgical skills can reduce the recurrence rate.

参考文献/References:

[1]李军,付强.经皮内镜椎板间入路治疗钙化型腰椎间盘突出症早期临床疗效分析[J].中国骨与关节杂志,2014,3(8):597-602.
[2]周春,李新锋.腰椎间孔内镜治疗高龄腰椎管狭窄症短期疗效的初步研究[J].中华骨与关节外科杂志,2017,10(2):95-99.
[3]Lee JC,Kim Y,Soh JW,et al.Risk factors of adjacent segment disease requiring surgery after lumbar spinal fusion: comparison of posterior lumbar interbody fusion and posterolateral fusion[J].Spine(Phila Pa 1976),2014,39(5):E339-E345.
[4]陈晓庆,张烽,于江,等.经皮椎间孔入路内镜下减压治疗老年腰椎侧隐窝狭窄症[J].中国脊柱脊髓杂志,2016,26(3):233-238.
[5]Gibson JN,Cowie JG,Iprenburg M.Transforaminal endoscopic spinal surgery:the future'gold standard' for discectomy? - A review[J].Surgeon,2012,10(5):290-296.
[6]李长青,周跃,王建,等.经皮内窥镜下手术治疗腰椎间盘突出症的并发症及其防治策略[J].中国脊柱脊髓杂志,2012,22(11):969-974.
[7]郑旭浩,张小磊,江立波,等.细胞自噬在糖尿病大鼠椎间盘退变中的作用[J].中国病理生理杂志,2013,29(11):2011-2016.
[8]王剑锋,杨林.腰椎间孔镜术后复发的原因分析及对策[J].武警医学,2017,28(4):366-368.
[9]Iprenburg M,Wagner R,Godschalx A,et al.Patient radiation exposure during transforaminal lumbar endoscopic spine surgery: a prospective study[J].Neurosurg Focus,2016,40(2):E7.
[10]石立刚,杨林,焦书敏,等.椎间孔镜治疗700例腰椎间盘突出症疗效的危险因素分析[J].实用医学杂志,2015,31(14):2337-2339.

相似文献/References:

[1]倪航航,梁志宏,刘书强,等.对Ⅲ度痔两种手术方式治疗效果的评价[J].医学信息,2018,31(11):107.[doi:10.3969/j.issn.1006-1959.2018.11.033]
　NI Hang-hang,LIANG Zhi-hong,LIU Shu-qiang,et al.Evaluation of the Effect of Two Kinds of Surgical Treatment for Ⅲ Degree Hemorrhoids[J].Journal of Medical Information,2018,31(01):107.[doi:10.3969/j.issn.1006-1959.2018.11.033]
[2]陶 洪,孙国平.非小细胞肺癌根治术后复发及进展影响因素的回顾性分析[J].医学信息,2018,31(12):61.[doi:10.3969/j.issn.1006-1959.2018.12.019]
　TAO Hong,SUN Guo-ping.Retrospective Analysis of Factors Influencing Recurrence and Progression after Radical Resection of Non-small Cell Lung Cancer[J].Journal of Medical Information,2018,31(01):61.[doi:10.3969/j.issn.1006-1959.2018.12.019]
[3]史世华,马天洪,山家玥,等.中药汤剂联合西药口服治疗痛风性关节炎预后的Meta分析[J].医学信息,2018,31(19):131.[doi:10.3969/j.issn.1006-1959.2018.19.039]
　SHI Shi-hua,MA Tian-hong,SHAN Jia-yue,et al.Meta-analysis of the Prognosis of Oral Traditional Chinese Medicine Decoction Combined with Western Medicine in the Treatment of Gouty Arthritis[J].Journal of Medical Information,2018,31(01):131.[doi:10.3969/j.issn.1006-1959.2018.19.039]
[4]刘 然.头颅MRI-DWI病灶数量及部位对脑梗死复发预测意义[J].医学信息,2018,31(22):172.[doi:10.3969/j.issn.1006-1959.2018.22.052]
　LIU Ran.The Significance of the Number and Location of MRI-DWI Lesions in Predicting the Recurrence of Cerebral Infarction[J].Journal of Medical Information,2018,31(01):172.[doi:10.3969/j.issn.1006-1959.2018.22.052]
[5]罗文广,童 敏,张克春,等.修正性鼻内镜手术治疗慢性鼻-鼻窦炎鼻内镜术后复发的处理措施研究[J].医学信息,2018,31(23):183.[doi:10.3969/j.issn.1006-1959.2018.23.054]
　LUO Wen-guang,TONG Min,ZHANG Ke-chun,et al.Treatment of Recurrence of Chronic Rhino-sinusitisafter Endoscopic Surgery by Modified Endoscopic Sinus Surgery[J].Journal of Medical Information,2018,31(01):183.[doi:10.3969/j.issn.1006-1959.2018.23.054]
[6]石 磊.改良性保乳保腋窝手术与传统保乳手术对 T1期乳腺癌患者复发的影响[J].医学信息,2019,32(11):119.[doi:10.3969/j.issn.1006-1959.2019.11.034]
　SHI Lei.Effect of Modified Breast-preserving Axillary Surgery and Traditional Breast-conserving Surgery on Recurrence of T1 Breast Cancer Patients[J].Journal of Medical Information,2019,32(01):119.[doi:10.3969/j.issn.1006-1959.2019.11.034]
[7]白梦箫,刘 晨.子宫内膜息肉的诊疗现状[J].医学信息,2019,32(20):45.[doi:10.3969/j.issn.1006-1959.2019.20.013]
　BAI Meng-xiao,LIU Chen.Current Status of Diagnosis and Treatment of Endometrial Polyps[J].Journal of Medical Information,2019,32(01):45.[doi:10.3969/j.issn.1006-1959.2019.20.013]
[8]肖 戈,尹 杰,林靖波,等.经皮肾镜碎石取石术的疗效及术后复发的危险因素分析[J].医学信息,2019,32(21):98.[doi:10.3969/j.issn.1006-1959.2019.21.030]
　XIAO Ge,YIN Jie,LIN Jing-bo,et al.Therapeutic Effect of Percutaneous Nephrolithotomy and Risk Factors for Postoperative Recurrence of Stones[J].Journal of Medical Information,2019,32(01):98.[doi:10.3969/j.issn.1006-1959.2019.21.030]
[9]朱文书,张理想,游杨杨,等.长链非编码RNA MIAT表达水平与心房颤动导管消融术后复发的关系[J].医学信息,2021,34(04):75.[doi:10.3969/j.issn.1006-1959.2021.04.020]
　ZHU Wen-shu,ZHANG Li-xiang,YOU Yang-yang,et al.Relationship Between the Expression Level of Long Non-coding RNA MIAT and Recurrence After Catheter Ablation of Atrial Fibrillation[J].Journal of Medical Information,2021,34(01):75.[doi:10.3969/j.issn.1006-1959.2021.04.020]
[10]史浩明,吴庆琛.ⅠB期肺腺癌术后复发转移因素研究[J].医学信息,2021,34(04):92.[doi:10.3969/j.issn.1006-1959.2021.04.024]
　SHI Hao-ming,WU Qing-chen.Study on the Factors of Postoperative Recurrence and Metastasis of Stage ⅠB Lung Adenocarcinoma[J].Journal of Medical Information,2021,34(01):92.[doi:10.3969/j.issn.1006-1959.2021.04.024]

更新日期/Last Update: 2019-01-22