| 椎间孔镜联合棘突间融合治疗老年人腰椎管狭窄症伴不稳 |
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投稿时间：2020-11-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 闫志刚 |
AN Zhi-gang |
北京市隆福医院骨科, 北京 100010 |
Department of Orthopaedics, Beijing Longfu Hospital, Beijing 100010, China |
ym15485@163.com |
| 王元利 |
WANG Yuan-li |
北京市隆福医院骨科, 北京 100010 |
Department of Orthopaedics, Beijing Longfu Hospital, Beijing 100010, China |
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| 施建锋 |
SHI Jian-feng |
北京市隆福医院骨科, 北京 100010 |
Department of Orthopaedics, Beijing Longfu Hospital, Beijing 100010, China |
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| 杨黎黎 |
YANG Li-li |
北京市隆福医院骨科, 北京 100010 |
Department of Orthopaedics, Beijing Longfu Hospital, Beijing 100010, China |
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| 刘壮 |
LIU Zhuang |
北京市隆福医院骨科, 北京 100010 |
Department of Orthopaedics, Beijing Longfu Hospital, Beijing 100010, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第3期，第249-254页 |
| DOI：10.12200/j.issn.1003-0034.2021.03.012 |
| 基金项目: |
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中文摘要:
目的：观察椎间孔镜联合棘突间融合术治疗老年人腰椎管狭窄症伴不稳的临床疗效。
方法：2018年2月至2019年2月诊治82例老年人腰椎管狭窄症伴不稳患者，分为对照组与观察组。对照组41例患者中男23例，女18例；年龄（68.9±4.1）岁；病程（14.1±5.7）个月；单节段病变5例，多节段病变36例；运用单纯Bacfuse棘突间融合手术治疗。观察组41例患者中男22例，女19例；年龄（69.1±4.0）岁；病程（14.4±5.5）个月；单节段病变6例，多节段病变35例；运用椎间孔镜手术联合Bacfuse棘突间融合术治疗。对比两组患者的临床疗效，视觉模拟评分（visual analogue scale，VAS），日本骨科协会评估腰痛程度（Japanese Orthopaedic Association scores，JOA），Oswestry功能障碍问卷表（Oswestry dability index，ODI），Lehmann腰椎功能评分，椎间盘后缘高度与椎间孔高度、并发症发生率与复发率。
结果：观察组临床疗效优于对照组；观察组术后的VAS评分低于对照组，JOA评分高于对照组，且术后3个月与末次随访时的ODI指数均低于对照组，Lehmann腰椎功能评分均高于对照组；椎间盘后缘高度与椎间孔高度均大于对照组；观察组并发症发生率与复发率（4.9%、0.0%）均低于对照组（19.5%、9.8%）；各组对比，差异有统计学意义（P<0.05）。
结论：椎间孔镜联合棘突间融合术治疗老年人腰椎管狭窄症伴不稳的临床效果理想，可减轻术后疼痛，提高腰椎功能，改善椎间盘后缘高度与椎间孔高度，且可降低发症发生率与复发率，值得临床推行。 |
| 【关键词】关节镜 腰椎 椎管狭窄 关节不稳定性 脊柱融合术 老年人 |
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| Clinical observation of transforaminal endoscopy combined with interspinous fusion in the treatment of lumbar spinal stenosis with instability in the elderly |
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ABSTRACT
Objective: To observe the clinical effect of transforaminal endoscopy combined with interspinous fusion in the treatment of lumbar spinal stenosis with instability in the elderly.
Methods: From February 2018 to February 2019,82 elderly patients with lumbar spinal stenosis and instability were divided into control group and observation group. In the control group,there were 23 males and 18 females;the age was (68.9±4.1) years;the course of disease was (14.1±5.7) months;there were 5 cases of single segment lesions and 36 cases of multi segment lesions;simple bacfuse interspinous fusion was used. In the observation group,there were 22 males and 19 females;the age was(69.1±4.0) years;the course of disease was(14.4±5.5) months;there were 6 cases of single segment lesions and 35 cases of multi segment lesions;they were treated with transforaminal endoscopic surgery combined with Bacfuse interspinous fusion. The clinical efficacy,visual analogue scale(VAS),Japanese Orthopaedic Association scores(JOA),Oswestry disability index(ODI),Lehmann lumbar function score,posterior disc height and intervertebral foramen height,complication rate and recurrence rate of the two groups were compared.
Results: The clinical efficacy of the observation group was better than that of the control group;the VAS score of the observation group was lower than that of the control group,the JOA score was higher than that of the control group,and the ODI index at 3 months after operation and at the last follow-up was lower than that of the control group,the Lehmann lumbar function score was higher than that of the control group;the posterior edge height of intervertebral disc and intervertebral foramen height were higher than those of the control group;the incidence of complications and recurrence rate(4.9% and 0.0%) of the observation group were lower than those of the control group(19.5%,9.8%),the difference was statistically significant(P<0.05).
Conclusion: The clinical effect of transforaminal endoscopy combined with interspinous process fusion in the treatment of lumbar spinal stenosis with instability in the elderly is ideal. It can reduce postoperative pain,improve lumbar function,improve the height of posterior edge of intervertebral disc and intervertebral foramen,and reduce the incidence and recurrence rate. It is worthy of clinical promotion. |
| KEY WORDS Arthroscopes Lumbar vertebrae Spinal stenosis Joint Instability Spinal fusion Aged |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 闫志刚,王元利,施建锋,杨黎黎,刘壮.椎间孔镜联合棘突间融合治疗老年人腰椎管狭窄症伴不稳[J].中国骨伤,2021,34(3):249~254 |
| 英文格式: | AN Zhi-gang,WANG Yuan-li,SHI Jian-feng,YANG Li-li,LIU Zhuang.Clinical observation of transforaminal endoscopy combined with interspinous fusion in the treatment of lumbar spinal stenosis with instability in the elderly[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(3):249~254 |
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