摘要
目的比较椎间孔镜技术（TESSYS）与传统开放手术在治疗伴有骨质疏松的腰椎管狭窄症患者的疗效及安全性。方法从2010年3月至2013年9月武警北京市总队第三医院收治伴有骨质疏松的腰椎管狭窄症患者78例，其中43例选择TESSYS法治疗，35例选择传统开放手术治疗。术前、术后及末次随访时采用视觉模拟评分法（VAS）评估疼痛程度，术前、术后及末次随访采用日本矫形外科联合会下腰痛评分系统（JOA）评估腰椎功能改善情况。比较两组手术时间、出血量和并发症发生率。结果两组患者术前VAS和JOA评分的差异无统计学意义（P〉0．05），术后VAS评分均显著下降（P〈0．05），JOA评分均显著升高（P〈0．05），且两组间VAS和JOA评分的差异无统计学意义（P〉0．05）；而TESSYS组的手术时间、出血量和并发症发生率显著少于开放手术组（P〈0．05）。结论与传统开放手术相比，TESSYS治疗伴有骨质疏松的腰椎管狭窄症疗效虽相当，但是安全性更高，具有手术时间短、出血量少，并发症少的优点。
Objective To compare the efficiency and safety of transforaminal endoscopic spine system （TESSYS） with open operation in the treatment of lumbar spinal stenosis accompanied by osteoporosis. Methods Seventy-eight patients with lumbar spinal stenosis accompanied by osteoporosis undergoing surgical treatment in our department from March 2010 to September 2013 were recruited in this study. They were divided into 2 groups, TESSYS group （n=43） and open operation group （n=35）. The degree of pain and lumbar function improvement were assessed using Visual Analogue Score （VAS） and Japanese Orthopaedics Association Lumbago Score （JOA） respectively, before and immediately after operation and at the end of follow-up. Operation time, bleeding volume and incidence of complications were compared between the 2 groups. Results There was no significant difference in VAS and JOA scores between 2 groups preoperatively （P 〉 0.05）. After operation, the VAS scores were decreased （P 〈 0.05）, and those of JOA were increased in both groups （P 〈 0.05）, hut there was no difference in the 2 scores between them （P 〉 0.05）. While, the operation time, bleeding volume and incidence of complications were obviously less in the TESSYS group than in the open operation group （P 〈 0.05）. Conclusion TESSYS has similar efficiency as open operation in the treatment of lumbar spinal stenosis accompanied by osteoporosis, but the former is superior in operation time, bleeding, and incidence of complications.
出处
《中华老年多器官疾病杂志》
2014年第7期507-511,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
