椎间孔镜下改良环锯技术部分切除增生上关节突治疗腰神经根卡压综合征的效果

目的 评估椎间孔镜下改良环锯技术部分切除增生上关节突(superior articular process,SAP),治疗SAP增生引起的腰神经卡压综合征(lumbar nerve root entrapment syndrome,LNRES)的效果.方法 选择2015-04至2019-07医院收治的LNRES患者10...

Lumbar nerve root entrapment syndrome treated with modified trephine and endoscopic partial resection of hyperplastic superior articular process

Objective To analyze the therapeutic effect of partial excision of hyperplastic SAP by modified trephine under the transforaminal approach,and of endoscopic debridement and decompression of nerve roots in the treatment of lumbar nerve root entrapment syndrome (LNRES) caused by the hyperplastic superior articular process.Methods Ten LNRES patients with 10 intervertebral foramina were selected between April 2015 and July 2019,all of whom were L_4/5 unilateral (left 4 right 6).They were scheduled to undergo the modified percutaneous trephine for partial resection of the hyperplastic upper articular process and debridement of intervertebral foramina.Preoperatively,1 week and 12 weeks postoperatively and during the last follow-up,these patients underwent functional examination,X-ray and CT examination,respectively.The VAS pain grading method,JOA low back pain scores and MacNab criteria were adopted.Results The postoperative imaging examination showed that the intervertebral foramina were well decompressed.The VAS scores 1 week and 12 weeks after surgery and during the last follow-up became significantly lower (P<0.05),especially during the last follow-up(P<0.05),but there was no significant difference between the three groups.JOA scores 1 week and 12 weeks postoperatively and during the last follow-up also became significantly lower(P<0.05),especially during the 12-week group and the last follow-up group (P<0.05),but there was no significant difference between these two groups.In terms of MacNab criteria,10 cases were good in the 1-week group,2 cases were good and 8 cases were excellent in the 12-week group,and 10 cases were excellent in the last follow-up group.Conclusions The modified trephine combined with endoscopic discectomy is a minimally invasive,simple,effective and inexpensive approach to LNRES.