退行性腰椎管狭窄症的“立体微创”治疗-论文.pdf

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1、中华临床医师杂志f电子版)2014年7第8卷第13期ChinJClinicians(Elec~omc删tion)．JuIv1．2014．V01．8,No．13·73-●临床论著·退行性腰椎管狭窄症的“立体微创"治疗丁宇乔晋琳付本升向东东张建军崔洪鹏钟毓贤刘倩杜薇【摘要】目的提出针对退行性腰椎管狭窄症(DLSS)“立体微创”治疗理念，并探讨其临床疗效。方法回顾性分析海军总医院疼痛诊疗中心采用“立体微创”治疗47例DLSS患者的临床资料。联合应用射频、臭氧、针刀等治疗技术，针对DLSS腰椎前、中、后柱不同部位，予以微创治疗。所有患者定期进行随访，分别于6个月

2、及末次随访进行疗效评估，记录视觉模拟VAS量表、腰椎疾患JOA评分、Oswestry功能残障量(ODD表及SF．36生活质量量表评定分值，比较不同时点的治疗结果，并计算临床治疗有效率。结果平均随访(14．4±8．4)个月，术后6个月治疗总有效率为91．49％，末次随访治疗总有效率达89．36％。随访显示VAS、JOA、ODI及sF一36分值均能维持在较满意水平，与术前相比有统计学差异(P<0．05)。临床症状改善满意，腰腿疼痛缓解、生活质量改善、社会活动适应性增加，无严重并发症发生。结论“立体微创”治疗DLSS疗效肯定，安全可靠，拓宽了脊柱微创手术的临床

3、适应证，值得推广。【关键词】椎管狭窄；外科手术，微创性：治疗结果：退行性Clinicalstudyof“three—dimensionalminimallyinvasive’’therapyaimingatdegenerativelumbarspinalstenosisDingYu,QiaoJinlin。FuBensheng,XiangDongdong,ZhangJianjun，iHongpeng,ZhongHtxian，LiuQian，DuWei．DepartmentofRehabilitationMedicineandPainTreatmentCen

4、ter,NavyGeneralHospital,Beijing100048,ChinaCorrespondingauthor：DingYu,Email：cosmosdingyu@163．com[Abstract]0bjectiveToputforwardthetreatmentconceptof‘'three—dimensionalminimaUyinvasive(TDMX)”therapyaimingatdegenerativelumbarspinalstenosis(DLSS)，andmeanwhile，toexploretherelatedclin

5、icaloutcome．MethodsAretrospectivestudywasconducted．Forty-sevenpatients、ⅣithDLSSweretreated、)lri也TDMItherapy．Combiningwithradiofrequency,oxygen—ozoneandneedleknifetechniques，weperformedminimallyinvasivesurgeryagainstthediferentsitesoftheanterior,middleandposteriorcolumnofthelumbar

6、spine．Allpatientswerefollowed—upregularly,andtheclinicaleficiencywasevaluatedatbothsixmonthsafterthesurgeryandthefinaltimepoint．ScoresofVisualAnalogueScale(VAS)，JOA，OswestryDisabilityIndex(ODI)andSF一36werecalculatedandrecorded．Thesescoresatdiferenttimepointswereanalyzedandcompare

7、d，andalso，theclinicaltreatmenteficiencywascalculated．ResultsThemeanfollow-upperiodwas(14．4~8．4、months．Thetotalefectiveratewas91．49％atsixmonthsafterTDMIsurgery,whilewas89．36％atthefinalfollow—up．Thefollow-updatashowedthatthescoresofVAS，JOA，ODIandSF一36couldmaintainedatawell-pleasing

8、level，whichpresentedsignificantdiference