Delta大通道脊柱内镜手术减压治疗腰椎椎管狭窄症的有效性及安全性

doi:10.3969/j.issn.1006-6233.2023.06.020

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Abstract Objective: To investigate the clinical effectiveness of Delta channel endoscopic spinal decompression in the treatment of lumbar spinal stenosis. Methods: A total of 95 patients with lumbar spinal stenosis admitted to our hospital from January 2021 to January 2022 were selected in this study. Among them, 48 patients were treated with Delta channel spinal endoscopic surgical decompression (observation group), and the other 47 patients were treated with unilateral double-channel spinal endoscopic treatment (control group). The differences of surgery-related clinical indicators, pain degree before and after surgery, Oswestry disability index (ODI), CT imaging parameters of spinal stenosis, and clinical efficacy were compared between the two groups. Results: The operation time of the patients in the observation group was shorter than that in the control group, and the operation bleeding volume was less than that in the control group, the difference was statistically significant (P<0.05). There was no statistically significant difference between the two groups in the postoperative time to the ground and hospital stay (P>0.05). Before operation, there was no significant difference in VAS score of waist pain and VAS score of leg pain between the observation group and the control group (P>0.05). After operation, the pain degree of waist and leg in the two groups was significantly reduced, and the VAS score was significantly lower than that before operation (P<0.05). Before operation, there was no statistically significant difference in the measured values of sagittal diameter of spinal canal (APDC), spinal canal area (CAC), area of vertebral canal (ICA), dural sac area (CAD) and epidural space (LAC) between the observation group and the control group (P>0.05); three months after operation, CT reexamination of patients in both groups showed that the stenosis of the spinal canal of the patients was improved very well, and the measured values of APDC, CAC, ICA, CAD and LAC in the lumbar intervertebral space were significantly higher than those in the group before operation (P<0.05); before operation, the lumbar function of the patients was evaluated by ODI. There was no significant difference in the ODI value between the observation group and the control group (P>0.05); the lumbar function of patients in the two groups was significantly improved after operation, and the measured value of ODI was significantly lower than that before operation (P<0.05). After operation, the postoperative complications were 8.33% in the observation group and 4.26% in the control group, with no significant difference (P>0.05). Conclusion: Both Delta channel endoscopic spinal decompression and unilateral double-channel endoscopic spinal decompression can achieve good clinical results in the treatment of lumbar spinal stenosis, but the former has the advantages of simple operation, less operation time, and less surgical blood loss.

Key words： Delta grand access Endoscopic surgery Lumbar spinal stenosis Oswestry disability index

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.06.020 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I6/983

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