CAJ | 학술논문

目的：评价经皮椎间孔镜下髓核摘除术（percutaneoustransforaminalendoscopicdiscectomy，PTED）和传统后路椎体间融合术（posteriorinterbodyfusion，PLIF）治疗老年性腰椎椎管狭窄症的临床疗效。方法回顾分析76例获完整随访的老年性腰椎椎管狭窄症患者的治疗情况。根据手术方法患者分为2组，A组41例行传统开放减压、PLIF，B组35例行PTED。记录2组患者围手术期观察指标、手术切口视觉模拟量表（vicualaneliguescale，VAS）评分、Oswestry功能障碍指数（Oswestrydisabilityindex，ODI）评价患者日常生活能力。结果与A组相比，B组手术时间、卧床时间、X线照射时间、出血量等指标显著降低（P＜0．01）。随访结果显示2组患者术后24个月较术后1个月ODI明显改善，B组改善优于A组（P＜0．05）。结论PTED在术中切口、出血量、术后恢复等方面具有优越性，是一种有效的治疗腰椎椎管狭窄的术式。
목적：평개경피추간공경하수핵적제술（percutaneoustransforaminalendoscopicdiscectomy，PTED）화전통후로추체간융합술（posteriorinterbodyfusion，PLIF）치료노년성요추추관협착증적림상료효。방법회고분석76례획완정수방적노년성요추추관협착증환자적치료정황。근거수술방법환자분위2조，A조41례행전통개방감압、PLIF，B조35례행PTED。기록2조환자위수술기관찰지표、수술절구시각모의량표（vicualaneliguescale，VAS）평분、Oswestry공능장애지수（Oswestrydisabilityindex，ODI）평개환자일상생활능력。결과여A조상비，B조수술시간、와상시간、X선조사시간、출혈량등지표현저강저（P＜0．01）。수방결과현시2조환자술후24개월교술후1개월ODI명현개선，B조개선우우A조（P＜0．05）。결론PTED재술중절구、출혈량、술후회복등방면구유우월성，시일충유효적치료요추추관협착적술식。
Objective To compare the clinical outcomes of lumbar percutaneous transforaminal endoscopic discectomy ( PTED) and traditional open decompression and posterior lumbar interbody fusion ( PLIF) for elder patients with lumbar spi-nal stenosis syndrome .Methods From January 2009 to December 2011, 76 patients with lumbar spinal stenosis treated by PTED or PLIF and followed up for over 24 months were analyzed retrospectively .In Group A, 41 patients were treated with traditional open decompression PLIF , while 35 cases underwent PTED in Group B .The operative time , X-ray exposure time , bed time, postoperative ambulation , operative incision visual analogue scale ( VAS) and blood loss were measured for both groups.Oswestry disability index ( ODI) was evaluated at 1 and 24 months after treatment for detection on daily living activity.Results Compared with Group A, Group B had shorter operation time, X-ray exposure time, bed time (P <0.01).The average blood loss, analgesic drug usage cases of Group B were better than those of Group A (P<0.05).The improvement of incision VAS of Group B was better than that of Group A (P<0.05).The ODI at postoperative 1 and 24 month were better than that before operation for both groups , but the Group B had more improvement (P<0.05).Conclusion PTED has advantages in incision , blood loss and postoperative recovery .It is an effective and safe procedure for the treatment for lumbar canal stenosis .