| 任京天,李世昌,王中宇,等.单侧双通道脊柱内镜技术联合术中神经监测仪治疗腰椎管狭窄症.骨科,2024,15(6): 495-500. |
| 单侧双通道脊柱内镜技术联合术中神经监测仪治疗腰椎管狭窄症 |
| Unilateral Biportal Endoscopy Combined with Neuromonitoring for the Treatment of Lumbar Spinal Stenosis |
| 投稿时间：2024-06-28 |
| DOI：10.3969/j.issn.1674-8573.2024.06.003 |
| 中文关键词: 单侧双通道内镜技术 神经监测 腰椎管狭窄症 微创 |
| 英文关键词: Unilateral biportal endoscopy Neuromonitoring Lumbar spinal stenosis Minimally invasive trauma |
| 基金项目:保定市科技计划项目（2441ZF048） |
|
| 摘要点击次数: 616 |
| 全文下载次数: 289 |
| 中文摘要: |
| 目的 探讨单侧双通道脊柱内镜（unilateral biportal endoscopy，UBE）技术联合术中神经监测仪治疗腰椎管狭窄症的临床疗效。方法 回顾性分析我科2021年5月至2023年5月收治的腰椎管狭窄症病人共57例，根据手术方式分为两组，UBE组（单纯UBE手术）25例，联合组（UBE联合神经监测仪）32例，记录两组病人手术时间、住院时间、随访时间、术后神经损伤并发症和其他并发症、是否复发等情况。比较两组术前、术后第1天、术后1个月及末次随访时疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）及改良MacNab标准评价结果。结果 所有手术均顺利完成，两组病人的手术时间、住院时间、随访时间相比，差异无统计学意义（P＞0.05）。UBE组和联合组神经损伤发生率相比（16% vs. 0），差异有统计学意义（P=0.032）。随着术前、术后1天、术后1个月和末次随访的时间推移，两组VAS评分和ODI指数均逐步降低，两两比较，差异有统计学意义（P＜0.05）；组间比较，术后第1天时，UBE组的VAS评分为（3.44±0.87）分，显著高于联合组的（2.88±0.66）分，差异有统计学意义（P＜0.05），其余指标组间比较，差异无统计学意义（P＞0.05）。末次随访时根据改良MacNab标准评价临床疗效，UBE组病人优良率达到92.00%，联合组优良率达到93.75%。结论 UBE治疗腰椎管狭窄症手术创伤小，恢复快，短期疗效满意；神经监测仪在UBE术中应用可缓解病人术后的早期疼痛并且可降低神经损伤的发生率。 |
| 英文摘要: |
| Objective To discuss the clinical efficacy of unilateral biportal endoscopy (UBE) combined with neuromonitoring for the treatment of lumbar spinal stenosis. Methods A retrospective analysis was conducted on a total of 57 patients with lumbar spinal stenosis admitted to our department from May 2021 to May 2023. They were divided into two groups based on surgical methods: 25 cases in UBE group (UBE surgery), and 32 cases in the combined group (UBE combined with neuromonitoring). The surgical time, hospitalization time, follow-up time, incidence of postoperative nerve injury complications and other complications, and recurrence were recorded. The visual analogue scale (VAS), Oswestry disability index (ODI), and modified MacNab criteria before surgery, 1 day after surgery, 1 month after surgery, and at the last follow-up were compared. Results All surgeries were successfully completed. There was no statistically significant difference in the surgical time, hospitalization time, and follow-up time between the two groups (P＞0.05). There was a statistically significant difference in the incidence of nerve injury between the UBE group and the combination group (16% vs. 0, P=0.032). With the passage of time before surgery, 1 day after surgery, 1 month after surgery, and the last follow-up, the VAS scores and ODI of both groups gradually decreased, and the difference was statistically significant (P＜0.05) when compared pairwise; at 1st day after surgery, the VAS score of the UBE group was 3.44±0.87, significantly higher than that of the combination group (2.88±0.66), and the difference was statistically significant (P＜0.05). There was no statistically significant difference in other indicators between the groups (P＞0.05). At the last follow-up, the clinical efficacy was evaluated according to the modified MacNab criteria, and the excellent and good rate of UBE group reached 92.00%, while the excellent and good rate of patients in the combined group reached 93.75%. Conclusion UBE treatment for lumbar spinal stenosis has minimal surgical trauma, fast recovery, and satisfactory short-term efficacy. Neuromonitoring can alleviate early postoperative pain and reduce the incidence of nerve damage in patients undergoing UBE surgery. |
|
查看全文
下载PDF阅读器 |
| 关闭 |
|
|
|
