中国内镜杂志2025，Vol.31Issue(12)：25-32,8.DOI:10.12235/E20250012
脊柱内镜侧后路联合减压术治疗腰神经根双卡综合征的临床疗效观察
Clinical observation of spinal endoscopic lateral posterior combined decompression surgery for the treatment of lumbar nerve root double crush syndrome
摘要
Abstract
Objective To observe the clinical efficacy,feasibility,safety and effectiveness of spinal endoscopic lateral posterior combined decompression in the treatment of lumbar nerve root double crush syndrome(DCS).Methods A retrospective analysis was conducted on the clinical data of 50 patients with lumbar nerve root DCS caused by disc degenerative change from September 2018 to September 2023.The patients were divided into the observation group(37 cases)and the control group(13 cases)according to different surgical methods.The observation group was treated with spinal endoscopic lateral posterior combined decompression technique,while the control group was treated with non-surgical techniques.The visual analogue scale(VAS)score for pain,Oswestry disability index(ODI),and Japanese Orthopaedic Association(JOA)score of the two groups of patients were compared before treatment,1 week after treatment,3 months after treatment,6 months after treatment,and 12 months after treatment.At the last follow-up,the modified Macnab criteria was used to evaluate the clinical efficacy.Lumbar MRI was used to assess the height of the intervertebral space and the modified Pfirrmann classification standard for intervertebral disc degeneration.Evaluate the safety of this surgery(including the occurrence of complications,recurrence and conversion to surgical treatment).Results All 50 patients successfully completed the treatment without any serious complications.The VAS score and ODI of the two groups of patients showed a downward trend after the operation,while the JOA score showed an upward trend,the VAS score and ODI of the observation group at each time point after the operation were significantly lower than those before the operation,and were also significantly lower than those of the control group.The JOA score was significantly higher than that before the operation,and was also significantly higher than that of the control group.The differences were statistically significant(P<0.05).The excellent and good rate of the observation group was 86.49%,significantly higher than 76.92%of the control group,and the difference was statistically significant(P<0.05).At the last follow-up of the two groups of patients,there was no statistically significant difference in the height of the intervertebral space and the Pfirrmann grade of intervertebral disc degeneration(P>0.05).Neither of the two groups of patients had serious complications such as nerve injury and cerebrospinal fluid leakage during the perioperative period.In the observation group,one patient had radiating pain in the lower limb after the operation.In the observation group,one case developed lumbar intervertebral disc re-protrusion 3 months after the operation.In the control group,3 cases were transferred to surgical treatment.Conclusion Compared with non-surgical treatment,spinal endoscopic lateral and posterior combined decompression can more safely and effectively relieve the pain degree of lumbar nerve root DCS patients,improve lower limb function,and has good clinical efficacy in the early and middle stages.It is worthy of clinical promotion and application.关键词
脊柱内镜/腰神经根/双卡综合征(DCS)/侧后路联合/手术治疗Key words
spinal endoscopy/lumbar spinal nerve roots/double crush syndrome(DCS)/lateral combined with posterior spinal endoscopy/surgical treatment分类
医药卫生引用本文复制引用
杜薇,丁至立,张建军,卢正操,白杰,王树龙,崔洪鹏,丁宇..脊柱内镜侧后路联合减压术治疗腰神经根双卡综合征的临床疗效观察[J].中国内镜杂志,2025,31(12):25-32,8.基金项目
解放军总医院第六医学中心创新培育基金(No:CXPY202415) （No:CXPY202415）
