中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2011年
3期
179-181,后插1
,共4页
杨圣%芦健民%赵德伟%辛培成%李新路%廉皓屹%邱兴%付大鹏
楊聖%蘆健民%趙德偉%辛培成%李新路%廉皓屹%邱興%付大鵬
양골%호건민%조덕위%신배성%리신로%렴호흘%구흥%부대붕
腰椎管狭窄症%微创手术%单侧入路%双侧减压
腰椎管狹窄癥%微創手術%單側入路%雙側減壓
요추관협착증%미창수술%단측입로%쌍측감압
Lumbar stenosis%Minimal invasive operation%Unilateral approach%Bilateral decompression
目的 对脊柱显微手术下单侧入路行双侧减压治疗腰椎管狭窄症的方法和疗效进行评估.方法 从2007年6月至2010年6月,在手术显微镜辅助下行单侧入路双侧减压治疗腰椎管狭窄症60例,以症状最重侧为入路侧,按常规手术方法显露椎板间隙,Caspar拉钩维持并显露术区,脊柱专用手术显微镜下同侧椎管减压,倾斜手术显微镜和手术床,使医生的视角能看清对侧椎管并减压.采用目测类比评分法(visual analogue scale,VAS)评估治疗前后疼痛状况.结果 60例中57例的神经症状完全缓解;3例好转.手术后VAS评分从术前的9.08±0.76降为术后的2.33±1.43,术后随访6～24个月,平均(12.0±4.7)个月,所有病例的症状无加重或复发.结论 脊柱外科专用显微镜下单侧入路双侧减压治疗腰椎管狭窄是一种有效的治疗方法.并且具有创伤小、痛苦少、恢复快、疗效佳、术后对脊柱的稳定性影响很小的优点.
目的 對脊柱顯微手術下單側入路行雙側減壓治療腰椎管狹窄癥的方法和療效進行評估.方法 從2007年6月至2010年6月,在手術顯微鏡輔助下行單側入路雙側減壓治療腰椎管狹窄癥60例,以癥狀最重側為入路側,按常規手術方法顯露椎闆間隙,Caspar拉鉤維持併顯露術區,脊柱專用手術顯微鏡下同側椎管減壓,傾斜手術顯微鏡和手術床,使醫生的視角能看清對側椎管併減壓.採用目測類比評分法(visual analogue scale,VAS)評估治療前後疼痛狀況.結果 60例中57例的神經癥狀完全緩解;3例好轉.手術後VAS評分從術前的9.08±0.76降為術後的2.33±1.43,術後隨訪6～24箇月,平均(12.0±4.7)箇月,所有病例的癥狀無加重或複髮.結論 脊柱外科專用顯微鏡下單側入路雙側減壓治療腰椎管狹窄是一種有效的治療方法.併且具有創傷小、痛苦少、恢複快、療效佳、術後對脊柱的穩定性影響很小的優點.
목적 대척주현미수술하단측입로행쌍측감압치료요추관협착증적방법화료효진행평고.방법 종2007년6월지2010년6월,재수술현미경보조하행단측입로쌍측감압치료요추관협착증60례,이증상최중측위입로측,안상규수술방법현로추판간극,Caspar랍구유지병현로술구,척주전용수술현미경하동측추관감압,경사수술현미경화수술상,사의생적시각능간청대측추관병감압.채용목측류비평분법(visual analogue scale,VAS)평고치료전후동통상황.결과 60례중57례적신경증상완전완해;3례호전.수술후VAS평분종술전적9.08±0.76강위술후적2.33±1.43,술후수방6～24개월,평균(12.0±4.7)개월,소유병례적증상무가중혹복발.결론 척주외과전용현미경하단측입로쌍측감압치료요추관협착시일충유효적치료방법.병차구유창상소、통고소、회복쾌、료효가、술후대척주적은정성영향흔소적우점.
Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.
