使用小切口椎间孔穿刺术治疗并发椎管狭窄的腰椎间盘突出症

A. A. Kadhim
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摘要

研究目的本研究的目的是比较小切口椎间孔镜治疗腰椎间盘突出症合并椎管狭窄症的替代方法与以往的传统椎板切除术:本次病例对照研究共纳入290名患者,分为两组。这些患者主诉腰椎间盘突出症并发腰椎段狭窄。研究组患者采用小切口椎间孔镜方法进行治疗,而对照组患者则采用后路椎板切除术和减压术进行治疗。这些患者是从伊拉克阿迪瓦尼耶省阿迪瓦尼耶教学医院骨科的就诊患者中回顾性选出的:研究组患者的平均住院时间显著低于对照组患者,分别为 6.03 ±2.08 天和 8.07 ±3.13 天(P< 0.001)。此外,干预组的平均手术损失明显低于对照组,分别为 52.12 ±5.17 毫升对 65.48 ±5.08 毫升(P< 0.001)。此外,与对照组患者相比,干预组患者的平均手术时间明显缩短,分别为 62.62 ±3.09 分钟对 87.09 ±3.47 分钟(P< 0.001)。与对照组相比,研究组的平均 "视觉模拟评分(VAS)"明显降低,分别为 3.09 ±1.15 对 6.08 ±2.17 (P<0.001)。研究组与对照组神经功能的平均 "日本矫形协会(JOA)评分 "比较见图 2。与对照组相比,干预研究组的平均 "日本矫形协会(JOA)评分 "明显更高,分别为 27.15 ± 3.07 对 20.18 ± 4.81(P< 0.001):小切口椎间孔镜技术与传统的椎板切除术相比,住院时间明显更短、手术时间更短、失血量更少、视觉疼痛评分更低、神经功能更好。 关键词:小切口椎间孔镜;腰椎间盘突出症;椎管狭窄症
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MANAGEMENT OF DISC HERNIATION AT THE LUMBAR REGION THAT IS COMPLICATED WITH SPINAL STENOSIS USING SMALL INCISION FENESTRATION
Objectives: The objective of the current study was to compare the alternative approach of smaller incision fenestration in managing lumbar disc herniation with spinal stenosis to previous conventional laminectomy procedures. Patients and methods: The current case-control study included a total of 290 patients who were represented by two groups. Those patients were complaining of herniation of the lumbar disc with a complication of stenosis of the lumbar segments. Patients in the study group were treated by a small incision fenestration approach, whereas patients in the control group were treated by posterior laminectomy and decompression. Those patients were selected retrospectively from the pool of patients visiting the orthopedic units of Adiwaniyah Teaching Hospital, Adiwaniyah province, Iraq. Results: Mean hospital stay of patients in the study group was lower in a significant way in comparison with that of patients in the control group, 6.03 ±2.08 days versus 8.07 ±3.13 days, separately (p< 0.001). Added to that, mean operative loss was significantly lower in a group of intervention in comparison with the control group, 52.12 ±5.17 ml versus 65.48 ±5.08 ml, respectively (p< 0.001). Added to that, mean operative time was lower in a significant way in the group of intervention in comparison with patients in the group of control, 62.62 ±3.09 minutes versus 87.09 ±3.47 minutes, respectively (p< 0.001). The mean“visual analogue score (VAS)” was significantly lower in the study group in comparison with the control group, 3.09 ±1.15 versus 6.08 ±2.17, respectively (p<0.001). A comparison of the mean “Japanese orthopedic association (JOA) score” for nerve function between the study group and the control group is shown in Figure 2. The mean “Japanese orthopedic association (JOA) score” was higher in a significant manner in the group of an intervention study in comparison with the control group, 27.15 ±3.07 versus 20.18 ±4.81, respectively (p< 0.001). Conclusion: Small incision fenestration techniques are associated with significantly less hospital stay, less duration of operation, less blood loss, less visual pain score and better nerve function in comparison with conventional laminectomy procedure. Keywords: smaller incision fenestration, lumbar disc herniation, spinal stenosis
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