没有融合的减压在患有低度退行性脊髓缩和狭窄症的患者中:长期患者报告的结果
Judith M P van Grafhorst1, Wilco C Peul1, Carmen L A Vleggeert-Lankamp2
1University Neurosurgical Center Holland, Leiden University Medical Center, Leiden, The Netherlands.
World neurosurgery
|November 4, 2024
概括
腰椎脊柱狭窄症的减压手术是有效的,即使是低度退行性脊柱疏松症. 这种方法的长期结果和满意度比没有脊髓缩的手术更高,因此不需要常规的融合.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 脊柱外科手术 脊柱外科手术
背景情况:
- 腰椎脊柱狭窄影响许多患有神经性听症的患者.
- 在这些患者中,三分之一的患者患有低度退行性脊髓缩.
- 在脊髓溶解过程中,仪器融合与减压相结合的必要性仍在争论中.
研究的目的:
- 为了评估无仪器融合解压性手术的长期临床结果.
- 为了比较患有症状脊柱狭窄症的患者和没有低度退行性脊柱疏松症的患者的结果.
主要方法:
- 对患者进行了回顾性队列研究,这些患者因腰椎脊柱狭窄而接受了解压性手术.
- 术后9年使用疼痛,功能和满意度问卷评估结果.
- 在不同组之间比较人口统计数据,手术技术,重新手术率和患者报告的结果.
主要成果:
- 在奥斯韦斯特里残疾指数,EuroQol-5D或苏黎世音调查问卷得分中,没有观察到群体之间的显著差异.
- 长期满意度率是可比的 (69%的脊髓缩与68%没有).
- 两组的重置率相似 (7%与6%对比).
结论:
- 仅靠减压手术就能为脊柱狭窄提供可比的长期临床结果和患者满意度,而不论是1级退行性脊柱疏松症.
- 在对症状性腰椎脊柱狭窄症进行减压时,仪器融合并不是常规必要的.
- 没有融合的减压是腰椎脊柱狭窄症的有效治疗选择,即使存在退行性脊柱松症.
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