经皮内镜椎间孔扩大成形术治疗高位腰椎管狭窄症的疗效

卢正操; 丁宇; 张建军; 崔洪鹏; 朱凯; 付本升; 李雯

doi:10.13898/j.cnki.issn.1000-2200.2020.05.010

经皮内镜椎间孔扩大成形术治疗高位腰椎管狭窄症的疗效

Effect of the expanded percutaneous endoscopic foraminal plasty in the treatment of high lumbar spinal stenosis

摘要

摘要:
目的探讨经皮内镜椎间孔扩大成形术治疗高位腰椎管狭窄症的临床疗效。
方法高位腰椎管狭窄症病人8例，均明确诊断为单节段高位腰椎管狭窄症，均采用经皮内镜椎间孔扩大成形术进行治疗。于术前和出院时及术后3、6个月对病人症状及腰部功能进行评价，术后6个月末次随访时采用MacNad功能评分评价病人治疗效果。
结果8例病人均在局部麻醉下顺利完成手术。病人术后各时间点的疼痛视觉模拟评分和腰椎Oswestry功能障碍指数均低于术前(P＜0.05～P＜0.01)，日本骨科协会评分均高于术前(P＜0.05)。术后随访6个月，无复发病例，末次随访时按照MacNad功能评分评价病人疗效，优6例，良1例，可1例，优良率达87.50%。
结论经皮椎间孔镜椎间孔区扩大成形术治疗高位腰椎管狭窄症安全、有效。

Abstract:
ObjectiveTo evaluate the effects of the expanded percutaneous endoscopic foraminal plasty in the treatment of high lumbar spinal stenosis.
MethodsEight patients with high lumbar spinal stenosis were treated with expanded percutaneous endoscopic foraminal plasty.The symptoms and waist function of the patients were evaluated before operation and after 3 and 6 months of operation.The therapeutic effects of patients was evaluated using MacNad function score at the end of 6 months after operation.
ResultsEight patients were successfully operated under local anesthesia.At each time point after surgery, the visual analog score of pain and lumbar Oswestry dysfunction index(ODI) in all cases were lower than those before surgery(P＜0.05 to P＜0.01), and the Japanese orthopaedic association score was higher than that before surgery(P＜0.05).No recurrence case was found during 6 months of following up.At the last following-up, the results of MacNad evaluation showed that the excellent in 6 cases, good 1 case and fair in 1 case were identified, and the excellent and good rate of which was 87.50%.
ConclusionsThe the expanded percutaneous endoscopic foraminal plasty in the treatment of high lumbar spinal stenosis is safe and effective.

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