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微创内镜下手术治疗退变性腰椎管狭窄症的研究进展

陈佳佳 崔志明

226001 江苏省,南通市第一人民医院脊柱外科

崔志明,Email: cjj05170418@126.com

摘 要:退变性腰椎管狭窄症是导致老年人腰腿痛的常见疾病。传统的全椎板减压术易导致医源性的腰椎不稳,腰椎滑脱等并发症,因此,近年来不主张大范围减压的术式。微创内镜下手术治疗退变性腰椎管狭窄症,由于创伤小、恢复快、对脊柱稳定性影响小等优点,已逐步应用于临床。但目前仍存在适应证把握不准、并发症发生率较高等问题,本文拟就微创内镜下手术治疗退变性腰椎管狭窄症的研究现状作一综述。

关键词:椎管狭窄; 椎管减压; 椎间盘镜; 椎间孔镜

Research progress of microendoscope-assisted spinal decompression surgery for degenerative lumbar spinal stenosis

Chen Jiajia, Cui Zhiming.

Department of Spine Surgery, Nantong First People's Hospital, Nantong 226001, China

Cui Zhiming, Email: cjj05170418@126.com

江苏省临床医学科技专项(BL2014061)

Abstract:Degenerative lumbar spinal stenosis is a common disease causing lumbocrural pain in older people. The conventional laminectomy can cause complications, including iatrogenic lumbar spine instability and spondylolisthesis, therefore, extensive decompression surgery does not advocate recent years. Microendoscope-assisted spinal decompression surgery for degenerative lumbar spinal stenosis has the advantages of less-injury, speedy recovery, and small influence on the stability of the spine, has gradually been applied in clinic. However, there are still some problems such as inappropriate indications and high morbidity of complication. In this review, we discussed the current status of microendoscope- assisted spinal decompression surgery for degenerative lumbar spinal stenosis.

Key words:Spinal stenosis; Laminectomy; Microendoscopy discectomy; Percutaneous endoscopic lumbar discectomy

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文献标引:陈佳佳 崔志明.微创内镜下手术治疗退变性腰椎管狭窄症的研究进展[J/CD].中华临床医师杂志:电子版,2017,11(3):458.

参考文献:
  [1] Aizawa T, Kokubun S, Ozawa H, et al. Increasing Incidence of Degenerative Spinal Diseases in Japan during 25 Years: The Registration System of Spinal Surgery in Tohoku University Spine Society[J]. Tohoku J Exp Med, 2016, 238(2): 153-163.

  [2] Yabuki S, Fukumori N, Takegami M, et al. Prevalence of lumbar spinal stenosis, using the diagnostic support tool, and correlated factors in Japan: a population-based study[J]. J Orthop Sci, 2013, 18(6): 893-900.

  [3] Ghogawala Z, Dziura J, Butler WE, et al. Laminectomy plus Fusion versus Laminectomy Alone for Lumbar Spondylolisthesis[J]. N Engl J Med, 2016, 374(15): 1424-1434.

  [4] Fujimoto T, Taniwaki T, Tahata S, et al. Patient outcomes for a minimally invasive approach to treat lumbar spinal canal stenosis: is microendoscopic or microscopic decompressive laminotomy the less invasive surgery[J]. Clin Neurol Neurosurg, 2015, 131: 21-25.

  [5] Simotas AC. Nonoperative treatment for lumbar spinal stenosis[J]. Clin Orthop Relat Res, 2001(384): 153-161.

  [6] Mobbs RJ, Li J, Sivabalan P, et al. Outcomes after decompressive laminectomy for lumbar spinal stenosis: comparison between minimally invasive unilateral laminectomy for bilateral decompression and open laminectomy: clinical article[J]. J Neurosurg Spine, 2014, 21(2): 179-186.

  [7] Yang JC, Kim SG, Kim TW, et al. Analysis of factors contributing to postoperative spinal instability after lumbar decompression for spinal stenosis[J]. Korean J Spine, 2013, 10(3): 149-154.

  [8] Harris EB, Sayadipour A, Massey P, et al. Mini-open versus open decompression and fusion for lumbar degenerative spondylolisthesis with stenosis[J]. Am J Orthop, 2011, 40(12): E257-E261.

  [9] Radcliff K, Curry P, Hilibrand A, et al. Risk for adjacent segment and same segment reoperation after surgery for lumbar stenosis: a subgroup analysis of the Spine Patient Outcomes Research Trial (SPORT)[J]. Spine, 2013, 38(7): 531-539.

  [10] Adachi K, Futami T, Ebihara A, et al. Spinal canal enlargement procedure by restorative laminoplasty for the treatment of lumbar canal stenosis[J]. Spine, 2003, 3(6): 471-478.

  [11] O'Leary PF, McCance SE. Distraction laminoplasty for decompression of lumbar spinal stenosis[J]. Clin Orthop, 2001(384): 26-34.

  [12] Yücesoy K, Ozer E. Inverse laminoplasty for the treatment of lumbar spinal stenosis[J]. Spine, 2002, 27(13): E316- E320.

  [13] Kleeman TJ, Hiscoe AC, Berg EE. Patient outcomes after minimally destabilizing lumbar stenosis decompression: the "Port-Hole" technique[J]. Spine, 2000, 25(7): 865-870.

  [14] Weiner BK, Walker M, Brower RS, et al. Microdecompression for lumbar spinal canal stenosis[J]. Spine, 1999, 24(21): 2268-2272.

  [15] Wilke HJ, Drumm J, Haussler K, et al. Biomechanical effect of different lumbar interspinous implants on flexibility and intradiscal pressure[J]. Eur Spine J, 2008, 17(8): 1049-1056.

  [16] Moojen WA, Arts MP, Jacobs WC, et al. Interspinous process device versus standard conventional surgical decompression for lumbar spinal stenosis: randomised controlled trial[J]. Br J Sports Med, 2015, 49(2): 135.

  [17] 黎庆初, 谭斌, 刘雄文, 等. 显微内窥镜下应用改良器械减压治疗腰椎管狭窄症[J]. 中国脊柱脊髓杂志, 2008, 18(5): 341-344.

  [18] 田小武, 张贤, 黄承军, 等. 腰椎神经根管狭窄的区域划分与MED手术[J]. 骨与关节损伤杂志, 2004, 19(4): 224-226.

  [19] 王宸, 吴小涛, 卜星平, 等. 椎板间隙入路椎间盘镜治疗腰椎管狭窄症[J]. 中国矫形外科杂志, 2003, 11(12): 823-825.

  [20] 陆晓生, 赵劲民, 彭昊, 等. 改良脊柱显微内窥镜系统手术治疗腰椎管狭窄症的前瞻性研究[J]. 中国骨与关节损伤杂志, 2013, 28(5): 412-414.

  [21] Foley KT, Lefkowitz MA. Advances in minimally invasive spine surgery[J]. Clin Neurosurg, 2002, 49: 499-517.

  [22] Wu H, Yu WD, Jiang R, et al. Treatment of multilevel degenerative lumbar spinal stenosis with spondylolisthesis using a combination of microendoscopic discectomy and minimally invasive transforaminal lumbar interbody fusion[J]. Exp Ther Med, 2013, 5(2): 567-571.

  [23] 周跃, 李长青, 王建, 等. 经皮椎间孔成形术治疗L5/S1神经根管狭窄症[J]. 中国脊柱脊髓杂志, 2009, 19(5): 345-349.

  [24] 许勇, 陈仙, 李利平, 等. 经皮椎间孔镜治疗腰椎管狭窄症的体会[J]. 中国骨与关节损伤杂志, 2013, 28(7): 651-652.

  [25] Knight MT, Jago I, Norris C, et al. Transforaminal endoscopic lumbar decompression & foraminoplasty: a 10 year prospective survivability outcome study of the treatment of foraminal stenosis and failed back surgery[J]. Int J Spine Surg, 2014, 1: 8.

  [26] Jacquot F, Gastambide D. Percutaneous endoscopic transforaminal lumbar interbody fusion: is it worth it?[J]. Int Orthop, 2013, 37(8): 1507-1510.

  [27] 张西峰, 王岩, 肖嵩华, 等. 经皮内窥镜下椎间盘摘除B-Twin可膨胀椎间融合器临床应用[J]. 中国修复重建外科杂志, 2011, 25(10): 1153-1157.

  [28] Chen HT, Tsai CH, Chao SC, et al. Endoscopic discectomy of L5-S1 disc herniation via an interlaminar approach: Prospective controlled study under local and general anesthesia[J]. Surg Neurol Int, 2011, 2: 93.

  [29] Li ZZ, Hou SX, Shang WL, et al. The strategy and early clinical outcome of full-endoscopic L5/S1 discectomy through interlaminar approach[J]. Clin Neurol Neurosurg, 2015, 133: 40-45.

  [30] Alimi M, Njoku I Jr, Cong GT, et al. Minimally invasive foraminotomy through tubular retractors via a contralateral approach in patients with unilateral radiculopathy[J]. Neurosurgery, 2014, 10 Suppl 3: 436-447; discussion 446-467.

  [31] Kulkarni AG, Bassi A, Dhruv A. Microendoscopic lumbar discectomy: Technique and results of 188 cases[J]. Indian J Orthop, 2014, 48(1): 81-87.

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