张同会;李涛;吴从俊;李莹;唐谨;刘鏐;熊承杰;徐峰;

• 1:湖北六七二中西医结合骨科医院
• 2:中部战区总医院

摘要(Abstract)：

[目的]介绍改良椎间孔镜技术治疗老年性腰椎侧隐窝狭窄症的手术技术与临床效果。[方法] 2016年5月～2017年5月对27例单节段腰椎侧隐窝狭窄症老年患者采用MPTED。定位后建立工作通道,镜下切除黄韧带,对有根性症状患者,继续将工作套筒移动至神经根及硬膜囊腹侧,显露硬膜囊、神经根,对伴有钙化者,可用磨钻、反向刮匙处理,围绕神经根进行减压,直至硬膜囊及神经根背侧、腹侧均减压彻底,双极射频对残余髓核组织进行皱缩。[结果] 27例患者均顺利完成手术,1例术中造成硬膜囊撕裂、脑脊液漏,另1例术后出现下肢麻木不适,随访恢复可;所有患者获得(14.36±4.21)个月随访;术后各时间点腰腿痛VAS、ODI评分均较术前显著降低,差异有统计学意义(P<0.05);末次随访按改良MacNab标准,临床结果评定为优17例,良8例,可2例,差0例;优良率为92.60%。[结论]改良椎间孔镜技术治疗老年性腰椎侧隐窝狭窄症近期疗效良好,是一种安全、有效的微创手术方式,但具有一定的学习曲线。

关键词(KeyWords)： 腰椎管狭窄症;经皮椎间孔镜术;微创技术

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(编号:81401802)

作者(Authors): 张同会;李涛;吴从俊;李莹;唐谨;刘鏐;熊承杰;徐峰;

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