经皮内镜腰椎融合术治疗单节段退行性腰椎管狭窄症患者的效果及对其疼痛程度的影响OA
Effect of Percutaneous Endoscopic Lumbar Interbody Fusion in the Treate-ment of Patients with Single-Level Degenerative Lumbar Spinal Stenosis and Its Impact on Pain Severity
目的 分析经皮内镜腰椎融合术(PELIF)治疗单节段退行性腰椎管狭窄症(DLSS)患者的效果及对其疼痛程度的影响.方法 回顾性分析 2020 年 12 月至 2024 年 12 月我院收治的 56 例单节段DLSS患者,按照不同手术方式分为观察组(n=26,行PELIF)和对照组[n=30,予以常规Quadrant通道辅助下微创经椎间孔腰椎椎间融合术(MIS-TLIF)].对比两组的围术期指标,并发症情况,影像学结果,腰痛、腿痛VAS评分,以及Oswestry功能障碍指数(ODI).结果 与对照组相比,观察组的术中出血量较少,术后住院时间较短(P<0.05);两组的手术时间及并发症发生率比较,无统计学差异(P>0.05).两组术前、术后 1周及末次随访时的椎间隙高度、腰椎前凸角比较,无统计学差异(P>0.05).两组术后 6 个月及末次随访时的椎间融合成功率比较,无统计学差异(P>0.05).观察组术后1周及1个月的腰痛VAS评分、腿痛VAS评分、ODI均明显低于对照组(P<0.05).结论 与MIS-TLIF相比,PELIF治疗单节段DLSS安全有效,具有创伤小、术后疼痛缓解快、功能恢复迅速的优势;其早期镇痛效应源于内镜下精准减压、减少软组织牵拉损伤,可为DLSS的微创治疗提供有效新选择.
Objective To analyze the effect of percutaneous endoscopic lumbar interbody fusion(PELIF)in the treatment of patients with single-level degenerative lumbar spinal stenosis(DLSS)and its impact on pain severity.Methods A retrospective analysis was conducted on 56 patients with single-level DLSS admitted to our hospital from December 2020 to December 2024.The patients were divided into the observation group(n=26,treated with PELIF)and the control group[n=30,treated with conventional Quadrant channel-assisted minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)]according to different surgical methods.The perioperative indicators,complications,imaging results,VAS scores of low back pain and leg pain,and Oswestry Disability Index(ODI)were compared between the two groups.Results Compared with the control group,the intraoperative blood loss of the observation group was less,and the postoperative hospital stay was shorter(P<0.05).No statistical difference was found in the operation time and incidence of complications between the two groups(P>0.05).No statistical difference was found in the intervertebral space height and lumbar lordosis angle between the two groups preoperatively,at 1 week after surgery,and at the last follow-up(P>0.05).No statistical difference was found in the success rate of interbody fusion between the two groups at 6 months after surgery and at the last follow-up(P>0.05).The VAS scores of low back pain and leg pain,as well as ODI in the observation group were significantly lower than those in the control group at 1 week and 1 month after surgery(P<0.05).Conclusions Compared with MIS-TLIF,PELIF is safe and effective in the treatment of single-level DLSS,with the advantages of minimal trauma,rapid postoperative pain relief,and fast functional recovery.Its early analgesic effect is derived from precise decompression under endoscopy and reduced soft tissue traction injury,which can provide an effective new option for the minimally invasive treatment of DLSS.
姚东元;郑杰;陆禹严;陈源;罗书钜
玉林市第一人民医院脊柱骨病外科,广西 玉林 537000玉林市第一人民医院脊柱骨病外科,广西 玉林 537000玉林市第一人民医院脊柱骨病外科,广西 玉林 537000玉林市第一人民医院脊柱骨病外科,广西 玉林 537000玉林市第一人民医院脊柱骨病外科,广西 玉林 537000
医药卫生
经皮内镜腰椎融合术微创经椎间孔腰椎椎间融合术单节段退行性腰椎管狭窄症疼痛程度
Percutaneous endoscopic lumbar interbody fusionMinimally invasive transforaminal lumbar interbody fusionSingle-level degenerative lumbar spinal stenosisPain severity
《临床医学工程》 2026 (3)
323-326,4
2022年玉林市科学研究与技术开发计划项目(项目编号:玉林科202235022)
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