CAJ | 학술논문

目的：评价经皮椎间孔镜治疗老年性腰椎管狭窄症的临床效果。方法：对2006年7月至2011年7月收治的60例老年性腰椎管狭窄症患者进行回顾性分析，其中男32例，女28例；年龄72～83岁，平均（66．7±2．5）岁。根据手术方法不同分为传统手术组和椎间孔镜组，每组30例。记录比较两组患者围手术期观察指标、手术切口VAS评分（术后12、24、48、72 h），采用Oswestry功能障碍指数（ODI评分）对两组患者术前，术后6、24个月的日常生活能力进行评定。结果：在手术时间、术中出血量、术后使用镇痛药物例数和住院时间的比较上，椎间孔镜组明显优于传统手术组（P＜0．05）。术后椎间孔镜组切口疼痛程度较传统手术组明显降低（P＜0．05）。60例患者均获得至少24个月的随访，两组患者于术后1、24个月时ODI评分均较术前明显改善，但椎间孔镜组患者ODI评分改善明显优于传统手术组患者（P＜0．05）。结论：腰椎经皮椎间孔镜技术在手术切口、术中出血量、住院时间等方面具有微创优越性，对脊柱稳定结构破坏小，患者术后恢复快，是治疗老年性腰椎管狭窄症的一种新的有效的微创手术方式。
목적：평개경피추간공경치료노년성요추관협착증적림상효과。방법：대2006년7월지2011년7월수치적60례노년성요추관협착증환자진행회고성분석，기중남32례，녀28례；년령72～83세，평균（66．7±2．5）세。근거수술방법불동분위전통수술조화추간공경조，매조30례。기록비교량조환자위수술기관찰지표、수술절구VAS평분（술후12、24、48、72 h），채용Oswestry공능장애지수（ODI평분）대량조환자술전，술후6、24개월적일상생활능력진행평정。결과：재수술시간、술중출혈량、술후사용진통약물례수화주원시간적비교상，추간공경조명현우우전통수술조（P＜0．05）。술후추간공경조절구동통정도교전통수술조명현강저（P＜0．05）。60례환자균획득지소24개월적수방，량조환자우술후1、24개월시ODI평분균교술전명현개선，단추간공경조환자ODI평분개선명현우우전통수술조환자（P＜0．05）。결론：요추경피추간공경기술재수술절구、술중출혈량、주원시간등방면구유미창우월성，대척주은정결구파배소，환자술후회복쾌，시치료노년성요추관협착증적일충신적유효적미창수술방식。
Objective:To evaluate the clinical outcomes of percutaneous intervertebral foramina endoscopic lumbar dis-cectomy for elder patients with lumbar spinal stenosis syndrome. Methods:From July 2006 to July 2011,60 elder patients with lumbar spinal stenosis syndrome were treated with surgical operation ,including 32 males and 28 females with an average age of (66.7±2.5) years old ranging from 72 to 83 years. These patients were divided into the traditional surgery group and percuta-neous intervertebral foramina endoscopic discectomy groups (PTED group),30 cases in each group. The index of the preoper-ative and postoperative,operative incision visual analogue scale (VAS) of two groups were compared. The Oswestry disability index (ODI) of two groups at 6,24 months of the follow up were also evaluated on activity of daily living. Results:The average operative time,the average blood loss,the number of cases using analgesic drug,hospitalization time of PTED group were better than those of the traditional surgery group (P<0.05). The improvement of incision VAS in PTED group was better than that in the traditional surgery group (P<0.05). All patients were followed up for 24 months at least. The ODI at 1 ,24 month after oper-ation were better than that of preoperative in two group respectively (P<0.05),but the improvement of PTED group was better than that of the traditional surgery group (P<0.05). Conclusion:PTED has the advantages of smaller incision,less bleeding, less postoperative stay and hospitalization time ,tissue trauma and quicker recovery. It is a safe and efficacious minimally inva-sive surgical technique for elder patients with lumbar spinal stenosis syndrome.