经皮椎间孔镜治疗高龄腰椎椎间盘突出并神经根管狭窄的短期疗效

摘要

Objective To evaluate clinical results of transforaminal endoscopic spine system(TESSYS) for treatment of intervertebral disk displacement with nerve root canal stenosis in elderly patient.Methods From November 2012 to June 2013, 12 elderly patients with typical radicular symptoms and neurogenic intermittent claudication were treated by TESSYS. There were 4 cases with prolapse of lumbar intervertebral disc and nerve root canal stenosis at L4/L5 and 3 cases at L5/S1 , 2 cases at L3/L4/L5 and 3 cases at L4/L5/S1 .The mean course of disease were 12.6 months.All patients were treated by TESSYS.Results Postoperative limb radicular symptoms and neurogenic intermittent claudication of 12 patients were relieved,straight leg raising test negative, the visual analogue scale ( VAS) score of limb pain was significantly decreased from preoperative 8.1 ±1.3 to postoperative 2.3 ±1.2 at 3 months after the surgery(P<0.05).Conclusion TESSYS is safe and efficacious in the treatment of elderly patient with prolapse of lumbar intervertebral disc and nerve root canal stenosis. Reasonable selection of operation indication and skilled operation is the key to a successful operation.%目的：评价经皮椎间孔镜技术治疗高龄腰椎椎间盘突出并神经根管狭窄的临床效果。方法选择2012年11月～2013年6月本院收治的12例有典型根性症状及间歇性跛行的高龄患者，其中L4／L5间隙4例，L5／S1间隙3例，L3／L4／L5双间隙2例，L4／L5／S1双间隙3例，平均病程12．6个月。均采用经皮椎间孔镜技术治疗。结果12例患者术后根性症状及间歇性跛行均明显缓解，直腿抬高试验阴性，采用疼痛视觉模拟量表（ visual analogue scale，VAS）为患肢疼痛程度评分，术前为（8．1±1．3）分，术后3个月为（2．3±1．2）分，差异具有统计学意义（P＜0．05）。结论治疗有典型根性症状及间歇性跛行的腰椎椎间盘突出并根管狭窄的高龄患者，经皮椎间孔镜技术微创、安全、有效，合理选择手术适应证和成熟的椎间孔镜手术经验是手术成功的关键。