论文部分内容阅读
[目的]探讨内镜下腰椎管成形术治疗腰椎退行性疾病的疗效.[方法]对2016年6月～2016年12月本院骨科五病区收治的腰椎退行性疾病患者随机分为两组,分别进行内镜下腰椎管成形术(内镜组)与减压植骨椎弓根钉内固定术(开放组).其中内镜下腰椎管成形术36例,减压植骨椎弓根钉内固定术42例.术前两组患者均行常规检查及专科检查,术后比较两种术式的切口长度、术中出血量、手术时间、术后卧床时间;记录并比较两组患者术前及术后2周、3个月、6个月的视觉疼痛模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分、日本矫形外科协会(JOA)评分进行评价.[结果]内镜组36例,男15例、女21例;开放组40例,男18例、女22例,两组患者均顺利完成手术及随访.内镜组与开放组相比较,手术切口短,术中失血量少,术后卧床时间缩短,术后下腰痛复发率低;两组比较手术时间无明显差异,术后早期VAS评分、JOA评分、ODI评分无明显差异.两组患者均未发生严重并发症.[结论]内镜下腰椎管成形术疗效确切、安全可靠,是一种值得推广的新术式.“,”[Objective] To compare the outcome of endoscopic pedicle screw fixation and traditional open surgery on lumbar degenerative disease.[Methods] From June 2016 to December 2016,76 patients with degenerative lumbar degenerative disease were randomly divided into the endoscopic and the traditional groups.In the former 36 patients received decompression by laminoplasty,combined with pedicle screw fixation using endoscopic technique,while in the latter 40 patients underwent traditional decompression and pedicle screw fixation using open technique.The incision length,intraoperative blood loss,operation time and postoperative bed rest were compared between the two groups.In addition,the visual analogue scale (VAS),the Oswestry Dysfunction Index (ODI) and the Japanese Orthopedic Association (JOA) score were used for evaluation of the consequences.[Results] Compared with the traditional Group,the endoscopic group had significantly shortened operation incision,with less intraoperative blood loss,less postoperative bed rest and considerably reduced recurrence rate of low back pain (P＜0.05).How ever,no significant differences between the two groups were noted in the operation time,the postoperative VAS score,the JOA score,ODI score (P＞0.05).No severer complication occurred in any patient in both groups.[Conclusion] Endoscopic technique for laminoplasty and pedicle screw fixation is a new kind of treatment for lumbar degenerative disease with high safety and reliable outcomes.