单侧入路椎间孔镜双侧减压治疗中老年腰椎管狭窄症的临床效果

目的分析单侧入路椎间孔镜双侧减压治疗中老年腰椎管狭窄症的临床效果。方法选取我院2018年8月至2019年1月收治的68例中老年腰椎管狭窄症患者,按随机投掷法将其分为参照组和研究组,各34例。参照组实施全椎板切除双侧减压治疗,研究组实施单侧入路椎间孔镜双侧减压治疗。比较两组患者的手术时间、切口长度、术中出血量、术后下床活动时间、术后并发症发生情况、腰椎功能和疼痛程度。结果两组手术时间无显著差异(P>0.05)。研究组的切口长度小于参照组,术中出血量少于参照组,且术后下床活动时间早于参照组(P<0.05)。参照组的并发症总发生率为29.41%,高于研究组的8.82%(P<0.05)。术后1、3个月,两组患者的ODI、VAS评分均低于术前,且研究组低于参照组(P<0.05)。结论单侧入路椎间孔镜双侧减压治疗腰椎管狭窄症的效果显著,手术创伤小且术后并发症发生率低,可有效改善患者腰椎功能障碍、减少术后疼痛,具有临床推广价值。

Clinical effect of transforaminal endoscopic bilateral decompression via unilateral approach in the treatment of middle-aged and elderly patients with lumbar spinal stenosis

Objective To analyze the clinical effect of transforaminal endoscopic bilateral decompression via unilateral approach in the treatment of middle-aged and elderly patients with lumbar spinal stenosis.Methods A total of 68 middle-aged and elderly patients with lumbar spinal stenosis admitted in our hospital from August 2018 to January 2019 were selected,and the patients were divided into reference group and study group by random throwing method,with 34 cases in each group.The reference group underwent total laminectomy and bilateral decompression treatment,and the study group underwent transforaminal endoscopic bilateral decompression via unilateral approach treatment.The operation time,incision length,intraoperative blood loss volume,time of postoperative activity out of bed,postoperative complications,lumbar function and pain degree were compared between the two groups.Results There was no significant difference in operation time between the two groups(P>0.05).The incision length in the study group was smaller than that in the reference group,the intraoperative blood loss volume was less than that in the reference group,and time of the postoperative activity out of bed was earlier than that in the reference group(P<0.05).The total incidence of complications in the reference group was 29.41%,which was higher than 8.82%in the study group(P<0.05).At 1 and 3 months after operation,ODI and VAS scores of the two groups were lower than those before operation,and those in the study group were lower than the reference group(P<0.05).Conclusion The transforaminal endoscopic bilateral decompression via unilateral approach in the treatment of lumbar spinal stenosis has a significant effect,with small surgical trauma and low incidence of postoperative complications,it can effectively improve patients'lumbar dysfunction and reduce postoperative pain,which has clinical promotion value.