Bilateral Operation of Lumbar Degenerative Central Spinal Stenosis in Full-endoscopic Interlaminar Technique With Unilateral Approach Prospective 2-year Results of 74 Patients
Bilateral Operation of Lumbar Degenerative Central Spinal Stenosis in Full-endoscopic Interlaminar Technique With Unilateral Approach Prospective 2-year Results of 74 Patients
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DOI：
10.1097/bsd.0b013e3181f9f55e
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发表时间：
2011-07-01
影响因子：
--
通讯作者：
Ruetten, Sebastian
中科院分区：
文献类型：
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作者：
Komp, Martin;Hahn, Patrick;Ruetten, Sebastian
研究设计：对退行性腰椎中央椎管狭窄症患者进行前瞻性研究，采用全内窥镜单侧技术进行双侧手术。目的：本前瞻性研究的目的是使用新设计的内窥镜和器械，检查全内窥镜双侧椎板间技术与单侧入路在退行性腰椎中央椎管狭窄症和主要腿部症状中的技术可能性。背景资料总结：在适当的情况下，广泛减压和椎板切除术仍然是退行性腰椎管狭窄症手术的首选方法。尽管如此，保留组织的手术正变得越来越普遍。由于内窥镜技术在手术技术和康复方面的优势，内窥镜技术已成为许多领域的标准。在脊柱，一个基本点是在连续的视觉控制下充分截骨的工具的开发。方法：对72例腰椎中央型椎管狭窄症患者行全内镜单侧减压术，随访2年。结果：70.8%的患者下肢疼痛消失或基本消失，22.2%的患者有偶发性疼痛。减压效果与常规手术相当。并发症发生率低。全内窥镜技术带来的优势，在这些领域：操作，并发症，创伤，和rehabilitation.Conclusions：记录的结果表明，全内窥镜椎板间双边减压与单边的方法是一个足够的和安全的补充和替代传统的程序时，适应症标准得到满足。同时，它还具有微创干预的优势。
Study Design: Prospective study of the patients with degenerative spinal central stenosis, operated bilateral in a full-endoscopic unilateral technique.Objective: The objective of this prospective study was to examine the technical possibilities of full-endoscopic interlaminar bilateral technique with unilateral approach in degenerative lumbar central spinal stenosis and predominant leg symptoms using new designed endoscopes and instruments.Summary of Background Data: Extensive decompression with laminectomy where appropriate, is often still described as the method of choice in the operation of degenerative lumbar spinal stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the advantages they offer in surgical technique and in rehabilitation. At the spine, 1 essential point was the developing of the instruments for sufficient bone resection under continuous visual control. This enabled the use in the operation of spinal canal stenoses.Methods: A total of 72 patients with lumbar central spinal stenosis full-endoscopic unilateral decompression were followed for 2 years. In addition to general and specific parameters, these measuring instruments were used: VAS, German version North American Spine Society Instrument, Oswestry Low-back Pain Disability Questionnaire.Results: The results show that 70.8% no longer have leg pain or it was nearly completely reduced and 22.2% have occasional pain. The decompression results were equal to those of conventional procedures. The complication rate was low. The full-endoscopic techniques brought advantages in these areas: operation, complications, traumatization, and rehabilitation.Conclusions: The recorded results show that the full-endoscopic interlaminar bilateral decompression with unilateral approach is a sufficient and safe supplement and alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.