不同减压方式对单侧双通道脊柱内镜治疗老年重度腰椎管狭窄的效果分析OA
Effect of different decompression methods on unilateral biportal endoscopy in the treatment of elderly patients with severe lumbar spinal stenosis
目的 探讨不同减压方式对单侧双通道脊柱内镜(UBE)治疗重度腰椎管狭窄症(LSS)的效果影响.方法 选取2021年9月至2024年6月我院采用UBE治疗的203例老年重度LSS患者,根据减压方式不同分为单侧组(102例)、双侧组(101例),单侧组术中行单侧减压,双侧组术中行双侧减压(同切口单侧入路双侧减压).比较2组患者围术期情况、解剖影像参数、视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)、并发症发生情况,并比较不同Charlson共病指数(CCI)值患者康复进程、并发症发生情况.结果 双侧组患者手术时间长于单侧组(P<0.05);双侧组患者术后即刻、术后3个月硬膜囊面积、腰椎管面积均大于单侧组(P<0.05);双侧组患者术后7 d、术后3个月VAS评分、ODI均低于单侧组(P<0.05);2组患者并发症总发生率比较,差异无统计学意义(P>0.05).CCI值>2分的患者术后首次下床活动时间、住院时间长于CCI值≤2分的患者(P<0.05).结论 相较于单侧减压,双侧减压治疗老年重度LSS手术时间较长,但能更好地恢复腰椎形态,减轻疼痛,改善腰椎功能,安全性较高,且患者病情越轻,术后康复越快.
Objective To investigate the effect of different decompression methods on the efficacy of the unilateral biportal endoscopy(UBE)in the treatment of severe lumbar spinal stenosis(LSS).Methods A total of 203 elderly patients with LSS who underwent UBE treatment in our hospital from September 2021 to June 2024 were selected and divided into the unilateral group(102 cases)and the bilateral group(101 cases)according to different decompression methods.The unilateral group underwent unilateral decompression during operation,while the bilateral group underwent bilateral decompression(with bilateral decompression through the same incision and unilateral approach)during operation.The perioperative conditions,anatomical image parameters,visual analogue scale(VAS)scores,Oswestry disability index(ODI),and complications were compared between the two groups.The rehabilitation progress and complications of patients with different Charlson comorbidity index(CCI)values were compared.Results The operation time of patients in the bilateral group was longer than that in the unilateral group(P<0.05).The dural sac area and lumbar spinal canal area of patients in the bilateral group were larger than those in the unilateral group immediately after operation and 3 months after operation(P<0.05).The VAS scores and ODI 7 days and 3 months after operation of patients in the bilateral group were lower than those in the unilateral group(P<0.05).There was no statistically significant difference in the total incidence of complications between the two groups of patients(P>0.05).The first time of getting out of bed after operation and hospital stay in patients with CCI value>2 scores were longer than those in patients with CCI value≤2 scores(P<0.05).Conclusion Compared with unilateral decompression,bilateral decompression for elderly patients with severe LSS takes a longer surgical time,but it can better restore lumbar shape,alleviate pain,improve lumbar function,and has higher safety,and the milder the patient's condition,the faster the postoperative recovery.
张治龙;王海英;马风华;侯彦杰
新疆医科大学第二附属医院脊柱外科,新疆 乌鲁木齐 830000新疆医科大学第二附属医院脊柱外科,新疆 乌鲁木齐 830000新疆医科大学第二附属医院脊柱外科,新疆 乌鲁木齐 830000新疆医科大学第二附属医院脊柱外科,新疆 乌鲁木齐 830000
医药卫生
腰椎管狭窄症双通道脊柱内镜技术减压解剖影像参数疼痛腰椎功能并发症康复进程
lumbar spinal stenosisbiportal endoscopic techniquedecompressionanatomical image parameterspainlumbar functioncomplicationsrehabilitation process
《局解手术学杂志》 2025 (9)
780-784,5
"天山英才"医药卫生高层次人才培养项目(TSYC202301B124)
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