显微外科手术单侧入路双侧减压治疗腰椎管狭窄症

目的 对脊柱显微手术下单侧入路行双侧减压治疗腰椎管狭窄症的方法和疗效进行评估.方法 从2007年6月至2010年6月,在手术显微镜辅助下行单侧入路双侧减压治疗腰椎管狭窄症60例,以症状最重侧为入路侧,按常规手术方法显露椎板间隙,Caspar拉钩维持并显露术区,脊柱专用手术显微镜下同侧椎管减压,倾斜手术显微镜和手术床,使医生的视角能看清对侧椎管并减压.采用目测类比评分法(visual analogue scale,VAS)评估治疗前后疼痛状况.结果 60例中57例的神经症状完全缓解;3例好转.手术后VAS评分从术前的9.08±0.76降为术后的2.33±1.43,术后随访6～24个月,平均(12.0±4.7)个月,所有病例的症状无加重或复发.结论 脊柱外科专用显微镜下单侧入路双侧减压治疗腰椎管狭窄是一种有效的治疗方法.并且具有创伤小、痛苦少、恢复快、疗效佳、术后对脊柱的稳定性影响很小的优点.

Abstract：

Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.

Under microscope bilateral decompression via unilateral approach for the treatment of lumbar stenosis

Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.