关节镜技术治疗退变性腰椎椎管狭窄症的临床效果

Treatment of degenerative lumbar spinal stenosis with unilateral biportal endoscopic spinal surgery using arthroscope

摘要:

目的 探讨利用关节镜进行单侧双通道脊柱内镜技术（UBE）治疗退变性腰椎椎管狭窄症的临床效果。方法 回顾性分析2021年1月－2021年5月该院利用关节镜行UBE技术治疗退变性腰椎椎管狭窄症并获得完全随访的患者16例。比较术前、术后1周及终末随访时视觉模拟评分（VAS）及腰椎Oswestry功能障碍指数（ODI）。用改良MacNab标准进行疗效评价，观察其疗效及并发症。结果 术后腰腿痛VAS和ODI均明显改善（P < 0.05）；改良MacNab标准评定：优7例，良8例，可1例，差0例，优良率93.8%，并发症有：硬膜囊损伤2例（包括硬膜囊撕裂1例）和术后短期复发1例。结论 利用关节镜进行UBE治疗退变性腰椎椎管狭窄症，可以取得良好的临床效果，特别适用于高龄患者。

Abstract:

Objective To explore the clinical effects in the treatment of degenerative lumbar spinal stenosis by the unilateral biportal endoscopy (UBE) spinal surgery using arthroscope.Methods Clinical data of 16 cases with degenerative lumbar spinal stenosis from January to May 2021 was retrospectively analyzed and totally followed- up after surgery. Compare the scores of VAS and ODI before operation and one week after operation and the follow-up, the efficacy evaluation was performed using modified MacNab system, the effectiveness and complications were observed.Results The VAS score in the back and leg pain and ODI of lumbar vertebral function, those two indexes were significantly improved (P < 0.05). Modified MacNab system:7 cases in excellent, 8 cases in good, 1 cases in fair and 0 cases in poor, with an excellent and good rate of 93.8%. The complications were: dural sac injury in 2 cases (including dural sac tear in 1 case) and short-term recurrence in 1 case.Conclusion The treatment of degenerative lumbar spinal stenosis by UBE spinal surgery using arthroscope can achieve good clinical results, especially for elderly patients.