椎弓根螺钉置入联合双侧椎板开窗减压术对腰椎管狭窄症并不稳患者腰椎功能的影响

doi:10.3969/j.issn.2095-378X.2023.02.003

外科研究与新技术 ›› 2023, Vol. 12 ›› Issue (2): 89-92.doi: 10.3969/j.issn.2095-378X.2023.02.003

椎弓根螺钉置入联合双侧椎板开窗减压术对腰椎管狭窄症并不稳患者腰椎功能的影响

王毅峰

厦门大学附属第一医院骨科, 福建厦门 361003

收稿日期:2023-03-02 发布日期:2023-09-08
作者简介:王毅峰（1986—）,男,硕士研究生,副主任医师,从事临床骨科工作;电子信箱：holy238@sina.com

Effect of pedicle screw implantation combined with bilateral laminectomy on lumbar function in patients with unstable lumbar spinal stenosis

WANG Yifeng

Department of Orthopedics, First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian, China

Received:2023-03-02 Published:2023-09-08

摘要/Abstract

摘要： 目的探析在腰椎管狭窄症并不稳患者中采用椎弓根螺钉置入联合双侧椎板开窗减压术治疗对腰椎功能的影响。方法选择2019年3月—2022年3月诊治的56例腰椎管狭窄并不稳患者进行回顾性分析,根据手术方式不同将其分为两组,对照组（n=28,行开放椎弓根螺钉内固定术）和观察组（n=28,行椎弓根螺钉置入+双侧椎板开窗减压术）。采用日本骨科协会评估治疗分数（JOA）、Oswestry功能障碍指数（ODI）评分评估两组术后腰椎功能,统计两组临床效果优良率。结果观察组术后6个月的JOA评分高于对照组,且ODI评分低于对照组（P<0.05）;观察组临床效果优良率为92.86%,高于对照组的67.86%（P<0.05）。结论采用椎弓根螺钉置入、双侧椎板开窗减压术联合治疗腰椎狭窄症并不稳患者,可获得良好的临床效果,改善其腰椎功能。

关键词: 开放椎弓根螺钉内固定术, 双侧椎板开窗减压术, 腰椎管狭窄症, 腰椎不稳

Abstract: Objective To explore the effect of pedicle screw implantation combined with bilateral laminectomy on lumbar function in patients with unstable lumbar spinal stenosis. Methods A total of 56 patients with unstable lumbar spinal stenosis diagnosed and treated from March 2019 to March 2022 were retrospectively analyzed and divided into two groups according to different surgical methods： control group （n=28, internal fixation with open pedicle screw） and observation group （n=28, pedicle screw placement + bilateral laminectomy decompression）. The postoperative lumbar function of the two groups was evaluated by the Japanese Orthopedic Association （JOA） and Oswestry dysfunction index （ODI） scores, and the excellent and good rate of clinical effect of the two groups was calculated. Results The JOA score of the observation group was higher than that of the control group 6 months after operation, and the ODI score was lower than that of the control group （P<0.05）. The excellent and good rate of clinical effect in the observation group was 92.86%, higher than 67.86% in the control group （P<0.05）. Conclusion The treatment of patients with unstable lumbar spinal stenosis with pedicle screw insertion and bilateral laminectomy can achieve good clinical results and improve their lumbar function.

Key words: Open pedicle screw internal fixation, Bilateral laminectomy, Lumbar spinal stenosis, Lumbar instability

中图分类号:

R683.2

王毅峰. 椎弓根螺钉置入联合双侧椎板开窗减压术对腰椎管狭窄症并不稳患者腰椎功能的影响[J]. 外科研究与新技术, 2023, 12(2): 89-92.

WANG Yifeng. Effect of pedicle screw implantation combined with bilateral laminectomy on lumbar function in patients with unstable lumbar spinal stenosis[J]. Surgical Research and New Technique, 2023, 12(2): 89-92.

参考文献

[1] Siller S, Pannenbaecker L, Tonn JC,et al.Surgery of degenerative thoracic spinal stenosis-long-term outcome with quality-of-life after posterior decompression via an uni- or bilateral approach[J].Acta Neurochir, 2020, 162(2):317-325.
[2] 腰椎管狭窄症手术治疗规范中国专家共识组.腰椎管狭窄症手术治疗规范中国专家共识(2014年)[J].中华医学杂志,2014,94(35):2724-2725.
[3] Kato S, Oshima Y, Oka H, et al.Comparison of the Japanese Orthopaedic Association (JOA) score and modified JOA (mJOA) score for the assessment of cervical myelopathy: a multicenter observational study[J].PLoS One,2015,10(4):e0123022.
[4] Fujimori T, Ikegami D, Sugiura T, et al.Responsiveness of the Zurich Claudication Questionnaire, the Oswestry Disability Index, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, the 8-Item Short Form Health Survey, and the Euroqol 5 dimensions 5 level in the assessment of patients with lumbar spinal stenosis[J].Eur Spine J, 2022,31(6): 1399-1412.
[5] 陈远明,梁佳维,韦俊江,等.关节镜技术治疗退变性腰椎椎管狭窄症的临床效果[J].中国内镜杂志,2022,28(11):1-7.
[6] 高尚聚, 李文毅, 张隆, 等.麻醉高风险高龄退变性腰椎管狭窄症患者经皮脊柱内镜下椎管减压术治疗效果研究[J].中国全科医学,2020,23(27):3433-3439.
[7] Hermansen E, Austevoll IM, Hellum C,et al.Comparable increases in dural sac area after three different posterior decompression techniques for lumbar spinal stenosis: radiological results from a randomized controlled trial in the NORDSTEN study[J]. Eur Spine J, 2020, 29(9): 2254-2261.
[8] 李南,刘雪梅,郭炜,等.开放椎弓根螺钉置入联合双侧椎板开窗减压术治疗腰椎管狭窄症并不稳患者的效果观察[J].解放军医药杂志,2022,34(1):85-88.
[9] Ko S, Oh T.Comparison of bilateral decompression via unilateral laminotomy and conventional laminectomy for single-level degenerative lumbar spinal stenosis regarding low back pain, functional outcome, and quality of life - A Randomized Controlled, Prospective Trial[J].J Orthop Surg Res, 2019, 14(1): 252.
[10] Bouknaitir JB, Carreon LY, Brorson S,et al.Wide laminectomy, segmental bilateral laminotomies, or unilateral hemi-laminectomy for lumbar spinal stenosis: five-year patient-reported outcomes in propensity-matched cohorts[J].Spine, 2021, 46(21): 1509-1515.

椎弓根螺钉置入联合双侧椎板开窗减压术对腰椎管狭窄症并不稳患者腰椎功能的影响

Effect of pedicle screw implantation combined with bilateral laminectomy on lumbar function in patients with unstable lumbar spinal stenosis

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