摘要
目的观察内窥镜下有限减压结合经皮椎弓根内固定治疗老年性腰椎管狭窄症的临床效果。方法2010年2月至2011年8月，应用可动性内窥镜下腰椎管有限减压结合经皮椎弓根螺钉内固定治疗老年退变性腰椎管狭窄的患者34例，比较术前、出院时、术后3个月、末次随访的VAS评分。按Nakai标准将患者出院前、术后3个月、末次随访时的疗效按优、良、可、差进行分级。结果术前与术后出院前、术后3个月、末次随访的VAS评分比较差异有统计学意义[（7．9±1．6）、（2．9±1．4）、（1．9±1．9）、（2．4±1．5）分，F：13．524，P=0．036]，术后3次VAS评分比较差异均无统计学意义（P均〉0．05）。术后末次随访时按Nakai标准进行效果评定：优32例，良1例，可1例，优良率97％。结论内窥镜下有限减压结合经皮椎弓根内固定治疗老年性腰椎管狭窄症疗效可靠，对脊柱及后背部肌肉的影响小。
Objective To investigate clinical effect of limited decompression under endoscope combined with percutaneous transpedicular screw fixation for treatment of degenerative lumbar spinal stenosis. Methods Thirty-four senile patients with lower lumbar spinal stenosis were selected as our subjects from February 2010 to August 2011, and were treated with limited decompression under endoscope combined with percutaneous transpedicular screw fixation through posterior approach. The VAS scores of all patients were collected at the four periods including pre-operation, leaving hospital, 3 months after operation, and the last follow-up. The therapeutic effectiveness for the postoperative follow-up was expressed as excellent, good, ordinary, and poor according to Nakai standard. Results The VAS scores at pre-operation, leaving hospital, 3 month after operation, and the last follow-up were （ 7.9 ± 1.6 ）, （ 2. 9 ± 1.4 ）, （ 1.9 ±1.9 ）, （ 2.4 ± 1.5 ） respectively,and the difference was significant（ F = 13. 524 ,P = 0. 036）. But no significant differences of VAS scores at three sequential tests after operation were observed （P 〉 0. 05）. In the last postoperative follow-up,32 cases were graded as excellent, 1 cases for good and 1 case for ordinary, and the excellent rate reached to 97%. Conclusion The therapeutic effectiveness of lumbar spinal stenosis limited decompression under endoscope combined with percutaneous transpedieular screw fixation is reliable. Furthermore, no side effects on spine and back muscles are observed.
出处
《中国综合临床》
2014年第1期4-7,共4页
Clinical Medicine of China
关键词
腰椎管狭窄症
经皮椎弓根内固定术
老年人
显微内窥镜
有限减压
Lumbar vertebral canal stenosis
Percutaneous pedicle screw internal fixation
elderly
Microendoscope
Limited decompression
