微创减压椎板间动态固定治疗腰椎退变性疾病
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1.武警河南省总队医院脊柱外科;2.河南省骨科医院郑州院区脊柱微创中心

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Minimally invasive decompression and interlaminar dynamic stabilization in the treatment of lumbar degenerative diseases
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1.Department of Spinal Surgery, Armed Police Corps Hospital of Henan Province;2.Armed Police Corps Hospital of Henan Province;3.The Center of Minimally invasive spinal surgery, Henan Orthopaedic Hospital

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    摘要:

    [目的] 评估微创减压椎板间动态固定治疗腰椎退变性疾病的临床疗效。[方法] 2015年1月至2017年10月治疗腰椎退变性疾病患者42例,在全麻下行微创减压椎板间动态固定术(IntraSPINE),记录围手术期资料;使用腰腿痛VAS评分、 ODI指数、改良MacNab标准评价临床疗效;测量椎间隙高度(DH)、椎间孔高度(FH)评价影像学疗效;记录围手术期及随访期间的并发症。[结果] 所有手术均顺利完成并获得3年以上随访。平均手术时间(76.43±16.83)min、术中出血(59.05±14.45)ml。腰腿痛VAS评分、ODI指数在术后均显著小于术前(P<0.05),末次随访MacNab优良率95.24%;术后DH及FH均较术前明显增加(P<0.05)。随访中1例出现相邻节段退变,余无其他并发症。[结论] 微创减压椎板间动态固定治疗腰椎退变性疾病的疗效满意。

    Abstract:

    [Objective] To evaluate the clinical outcomes of minimally invasive decompression and interlaminar dynamic stabilization for the treatment of lumbar degenerative diseases. [Methods] A retrospective study was conducted on 42 patients with lumbar degenerative diseases from January 2015 to October 2017. All patients underwent microdiscectomy and IntraSPINE implantation through minimally invasive Quadrant channel under general anesthesia. The perioperative data was recorded. The visual analog scale (VAS) of the back and leg pain, Oswestry dysfunction index (ODI), and the modified MacNab criteria were used to evaluate the clinical efficacy. The disc height (DH) and foraminal height (FH) measured on radiographs were used to evaluate the imaging efficacy. Complications during the perioperative and follow-up periods were recorded. [Results] All patients successfully completed the operation and were followed up for more than 3 years. The average operation time was (76.43±16.83) minutes, and the blood loss was (59.05±14.45)ml. The VAS and ODI scores were significantly improved after operation compared with those before operation (P<0.05), and the MacNab excellent and good rate at the last follow-up was 95.24%. In terms of radiographic assessment, the DH and FH significantly increased postoperatively compared with those before operation (P<0.05). During the follow-up, 1 case developed adjacent segment degeneration, and no other complications occurred. [Conclusion] The clinical outcomes of minimally invasive decompression and interlaminar dynamic stabilization in the treatment of lumbar degenerative diseases is satisfactory.

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  • 收稿日期:2022-01-19
  • 最后修改日期:2022-07-12
  • 录用日期:2022-10-09
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