椎间孔镜治疗退行性腰椎管狭窄症疗效分析及术后复发因素分析(1)
摘要：目的 分析經皮椎间孔镜治疗退行性腰椎管狭窄症疗效并统计术后复发病例，分析其发生原因，并归纳相关危险因素。方法 选取我科经皮椎间孔镜治疗退行性腰椎管狭窄症手术共188例进行为期1年的随访，分析手术疗效并对复发病例行二次椎间孔镜治疗，探讨术后复发原因，归纳相关危险因素。结果 本组术后评分改善明显，术后1年优良率为88.83%;术后共出现复发患者6例，占总数3.19%，复发原因为术中髓核摘除不彻底、术中定位不佳、术前合并终板炎、术后活动过多等;均经二次PELD治疗逐渐康复，术后1年改良MacNab疗效评定4例优，1例良，1例可;术前合并终板炎9例，其中3例复发。结论 经皮椎间孔镜治疗退行性腰椎管狭窄症的短期疗效确切，安全性高，术前合并终板炎可能为影响术后复发的高危因素，术前严格掌握手术适应证、把控相关危险因素、提高手术技巧可降低术后复发率。
关键词：椎间孔镜;复发;危险因素;腰椎管狭窄
中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.01.035
, 百拇医药
文章编号：1006-1959(2019)01-0115-04
Analysis of the Efficacy of Intervertebral Foramen in the Treatment of Degenerative Lumbar Spinal Stenosis and Analysis of Postoperative Recurrence Factors
GAO Zheng-tian，JIA Tian-yang，CHANG Cheng-bing，CHEN Bin
(Department of Spinal Surgery，Affiliated Hospital of Chengde Medical College，Chengde 067000，Hebei，China)
Abstract：Objective To analyze the efficacy of percutaneous transforaminal lumbar stenosis in the treatment of degenerative lumbar spinal stenosis and to analyze the recurrence cases， and to analyze the causes and summarize the related risk factors. Methods A total of 188 patients with degenerative lumbar spinal stenosis underwent percutaneous transluminal angioplasty for one-year follow-up. The curative effect was analyzed and the patients with recurrent cases were treated with secondary intervertebral foramen. Induction of relevant risk factors. Results The postoperative scores of this group improved significantly. The excellent and good rate was 88.83% after 1 year. There were 6 cases of recurrence after operation， accounting for 3.19% of the total. The recurrence was due to incomplete nucleus pulposus removal and poor intraoperative positioning. Preoperative combined endplate inflammation， excessive postoperative activities， etc.; all gradually recovered by secondary PELD treatment， 4 cases of improved MacNab efficacy after 1 year of surgery， 1 case is good， 1 case was available; 9 cases of endplate inflammation were combined before operation， and 3 cases recurred. Conclusion The short-term curative effect of percutaneous transforaminal lumbar stenosis for degenerative lumbar spinal stenosis is safe and high. Preoperative combined endplate inflammation may be a risk factor for postoperative recurrence. Surgical indications and control are strictly controlled before operation. Risk factors and improved surgical skills can reduce the recurrence rate., 百拇医药(高正添 贾天阳 常成兵 陈宾)
关键词：椎间孔镜;复发;危险因素;腰椎管狭窄
中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.01.035
, 百拇医药
文章编号：1006-1959(2019)01-0115-04
Analysis of the Efficacy of Intervertebral Foramen in the Treatment of Degenerative Lumbar Spinal Stenosis and Analysis of Postoperative Recurrence Factors
GAO Zheng-tian，JIA Tian-yang，CHANG Cheng-bing，CHEN Bin
(Department of Spinal Surgery，Affiliated Hospital of Chengde Medical College，Chengde 067000，Hebei，China)
Abstract：Objective To analyze the efficacy of percutaneous transforaminal lumbar stenosis in the treatment of degenerative lumbar spinal stenosis and to analyze the recurrence cases， and to analyze the causes and summarize the related risk factors. Methods A total of 188 patients with degenerative lumbar spinal stenosis underwent percutaneous transluminal angioplasty for one-year follow-up. The curative effect was analyzed and the patients with recurrent cases were treated with secondary intervertebral foramen. Induction of relevant risk factors. Results The postoperative scores of this group improved significantly. The excellent and good rate was 88.83% after 1 year. There were 6 cases of recurrence after operation， accounting for 3.19% of the total. The recurrence was due to incomplete nucleus pulposus removal and poor intraoperative positioning. Preoperative combined endplate inflammation， excessive postoperative activities， etc.; all gradually recovered by secondary PELD treatment， 4 cases of improved MacNab efficacy after 1 year of surgery， 1 case is good， 1 case was available; 9 cases of endplate inflammation were combined before operation， and 3 cases recurred. Conclusion The short-term curative effect of percutaneous transforaminal lumbar stenosis for degenerative lumbar spinal stenosis is safe and high. Preoperative combined endplate inflammation may be a risk factor for postoperative recurrence. Surgical indications and control are strictly controlled before operation. Risk factors and improved surgical skills can reduce the recurrence rate., 百拇医药(高正添 贾天阳 常成兵 陈宾)