【摘要】：[目的]探討經(jīng)皮椎間孔鏡技術(shù)治療腰椎融合術(shù)后相鄰節(jié)段退變的臨床療效。[方法]回顧性分析2010年8月~2015年8月于本院應(yīng)用經(jīng)皮椎間孔鏡治療并獲得隨訪的23例腰椎融合術(shù)后相鄰節(jié)段退變患者的臨床資料,采用視覺模擬評(píng)分法(visual analogue scale/score,VAS)評(píng)估手術(shù)療效,應(yīng)用日本骨科協(xié)會(huì)(Japanese Orthopaedic Association Scores,JOA)評(píng)分對(duì)腰椎功能進(jìn)行評(píng)估,并計(jì)算JOA改善率,術(shù)后1年改良Mac Nab標(biāo)準(zhǔn)評(píng)估臨床療效。[結(jié)果]手術(shù)時(shí)間40~85 min,平均55 min;出血量5~25 ml,平均10 ml;住院時(shí)間3~14 d,平均7 d。所有患者隨訪6~24個(gè)月,平均13.5個(gè)月。術(shù)前VAS評(píng)分為(7.13±0.54)分,術(shù)后3 d為(2.05±0.34)分,末次隨訪為(1.41±0.28)分。術(shù)前與術(shù)后3 d、末次隨訪比較差異有統(tǒng)計(jì)學(xué)意義(P0.01);術(shù)前JOA評(píng)分為(9.89±0.53)分,出院當(dāng)天評(píng)分為(18.23±2.25)分,末次隨訪評(píng)分為(28.41±2.34)分,術(shù)前與出院時(shí)、末次隨訪比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)。根據(jù)JOA評(píng)分標(biāo)準(zhǔn)計(jì)算改善率,優(yōu)18例,良3例,可1例,差1例;術(shù)后1年優(yōu)良率為91.3%。[結(jié)論]應(yīng)用經(jīng)皮椎間孔鏡治療腰椎融合術(shù)后相鄰節(jié)段退變性疾病療效確切,具有創(chuàng)傷小、手術(shù)時(shí)間短、恢復(fù)快、術(shù)后并發(fā)癥少等優(yōu)點(diǎn)。
[Abstract]:[objective] to investigate the clinical effect of percutaneous foramen technique in the treatment of adjacent segment degeneration after lumbar fusion. [methods] the clinical data of 23 patients with adjacent segmental degeneration after lumbar fusion were analyzed retrospectively from August 2010 to August 2015, and the results were evaluated by visual analogue score (visual analogue scale / score). The lumbar spine function was evaluated with (Japanese Orthopaedic Association Scores JOA score of Japan Orthopedic Association, the improvement rate of JOA was calculated, and the clinical curative effect was evaluated by modified Mac Nab standard one year after operation. [results] the operative time was 40 ~ 85 min (mean 55 min), blood loss was 525 ml (mean 10 ml), hospitalization time was 3 ~ 14 d (mean 7 d). All patients were followed up for 6 ~ 24 months (mean 13.5 months). The VAS score was (7.13 鹵0.54) before operation, (2.05 鹵0.34) on the 3rd day after operation, and (1.41 鹵0.28) at the last follow-up. There were significant differences between preoperative and postoperative 3 days, and the scores of JOA were (9.89 鹵0.53), (18.23 鹵2.25) and (28.41 鹵2.34), respectively. There was significant difference between preoperative and post-discharge follow-up (P0.01). According to the JOA score, the improvement rate was excellent in 18 cases, good in 3 cases, fair in 1 case and poor in 1 case, and the excellent and good rate was 91.3% one year after operation. [conclusion] Percutaneous foramen endoscopy is effective in the treatment of adjacent degenerative diseases after lumbar fusion. It has the advantages of less trauma, shorter operative time, faster recovery and less postoperative complications.
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本文編號(hào)：2149114