保国锋;李卫东;徐冠华;孙郁雨;王玲玲;陈佳佳;郭晓峰;姜佳伟;顾海燕;崔佰红;崔志明;

• 1:南通大学第二附属医院脊柱外科

摘要(Abstract)：

[目的]探讨经皮椎板间隙入路的椎管减压技术治疗伴有双侧侧隐窝狭窄的腰椎管狭窄症临床疗效。[方法]本组单节段双侧侧隐窝腰椎管狭窄症患者20例,采取单侧经皮椎板间隙入路,通过改变内镜的倾斜角度并利用角度椎板钳和镜下磨钻行双侧侧隐窝和中央椎管270°减压,随访时间超过24个月,分析术后疗效参数如VAS评分、ODI评分、Macnab分级评分、单次连续行走距离和手术并发症。[结果]术后影像学证实所有患者进行了有效的中央椎管和双侧侧隐窝的减压。术后ODI评分和VAS评分较术前显著降低,差异有统计学意义;Macnab评分,80%的患者取得了满意或良好的疗效;单次连续行走距离较术前明显增加。[结论]单侧经皮椎板间隙入路双侧侧隐窝和中央椎管270°减压术,具有良好的中央椎管和双侧侧隐窝手术视野显示,可有效减压,是微创治疗退变性椎管狭窄症特别是合并双侧侧隐窝狭窄的有效安全的手术方式。

关键词(KeyWords)： 腰椎管狭窄症;椎板间隙;减压;全脊柱内镜

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 保国锋;李卫东;徐冠华;孙郁雨;王玲玲;陈佳佳;郭晓峰;姜佳伟;顾海燕;崔佰红;崔志明;

Email:

DOI:

参考文献(References)：

• [1]Dezawa A,Mikami H,Sairyo K.Percutaneous endoscopic interlaminar approach for herniated nucleus pulposus in the hidden zone of the lumbar spine[J].Asian J Endosc Surg,2012,5(4):200-203.
• [2]Ahn Y.Percutaneous endoscopic decompression for lumbar spinal stenosis[J].Expert Rev Med Devices,2014,11(6):605-616.
• [3]Torudom Y,Dilokhuttakarn T.Two portal percutaneous endoscopic decompression for lumbar spinal stenosis:preliminary study[J].Asian Spine J,2016,10(2):335-342.
• [4]Wong AP,Smith ZA,Lall RR,et al.The microendoscopic decompression of lumbar stenosis:a review of the current literature and clinical results[J].Minim Invasive Surg,2012,2012(384):325095.
• [5]Asgar TF,Khoo LT.Minimally invasive operation management for lumbar spinal stenosis:overview of early and long-term outcomes[J].Orthop Clin North Am,2007,38:387-399.
• [6]Haba K,Ikeda M,Soma M,et al.Bilateral decompression of multilevel lumbar spinal stenosis through a unilateral approach[J].J Clin Neurosci,2005,12(2):169-171.
• [7]Thome C,Zevgaridis D,Leheta O,et al.Outcome after less-invasive decompression of lumbar spinal stenosis:randomized comparison of unilateral laminotomy,bilateral laminotomy,and laminectomy[J].J Neurosurg Spine,2005,3(2):129-141.
• [8]Khoo LT,Fessler RG.Microendoscopic decompressive laminotomy for the treatment of lumbar stenosis[J].Neurosurgery,2002,51:S146-154.
• [9]Ruetten S,Komp M,Hahn P,et al.Decompression of lumbar lateral spinal stenosis:full-endoscopic,interlaminar technique[J].Oper Orthop Traumatol,2013,25(1):31-46.
• [10]Ren L,Han Z,Zhang J,et al.Efficacy of percutaneous laser disc decompression on lumbar spinal stenosis[J].Lasers Med Sci,2014,29(3):921-923.
• [11]Nellensteijn J,Ostelo R,Bartels R,et al.Transforaminal endoscopic surgery for lumbar stenosis:a systematic review[J].Eur Spine J,2010,19(6):879-886.
• [12]李振宙,侯树勋,商卫林等.经皮腰椎间孔扩大成型器械的设计及临床运用[J].中华骨科杂志,2011,31(10):1026-1032.
• [13]Yadav YR,Parihar V,Kher Y,et al.Endoscopic inter laminar management of lumbar disease[J].Asian J Neurosurg,2016,11(1):1–7.
• [14]Hwa Eum J,Hwa Heo D,Son SK,et al.Percutaneous biportal endoscopic decompression for lumbar spinal stenosis:a technical note and preliminary clinical results[J].J Neurosurg Spine,2016,24(4):602-607.
• [15]Ruetten S,Komp M,Merk H,et al.Surgical treatment for lumbar lateral recess stenosis with the full-endoscopic interlaminar approach versus conventional microsurgical technique:a prospective,randomized,controlled study[J].J Neurosurg Spine,2009,10(5):476-485.