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一级与两级MIS减压与相邻水平狭窄症的结果

Tejas Subramanian^1,2, Pratyush Shahi¹, Takashi Hirase¹

¹Department of Spine Surgery, Hospital for Special Surgery, New York, NY, USA.

Global spine journal

|November 24, 2024

概括

对于腰椎狭窄症 (LSS),在患有相邻水平狭窄症的患者中,仅去压缩症状水平,可以获得相当于双层去压缩的结果. 这表明单一水平的手术可能足够,避免不必要的手术时间和风险.

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:

腰椎脊柱狭窄症 (LSS) 通常通过减压手术治疗.
邻近水平疾病是LSS患者经常发现的发现.
对LSS与无症状邻近狭窄症的最佳手术策略进行了讨论.

研究的目的:

为了比较单级与双级微创性解压缩 (MIS) 对于LSS的临床结果.
为了评估是否仅仅降低症状水平的压力,在邻近狭窄的病例中足够.
评估单级解压缩 (SLD) 和双级解压缩 (DLD) 之间的并发症和重新操作率.

主要方法:

对148名接受LSS初级MIS减压的患者进行了回顾性队列研究.
分析了症状单级狭窄和相邻水平狭窄的患者.
使用斯基萨斯对狭窄症严重性的分级来比较SLD (n=126) 和DLD (n=76) 的结果.

主要成果:

在SLD和DLD组之间,在术后2年内,患者报告的结果没有显著差异.
对紧缩症严重程度相匹配的子组分析也显示了同等的结果.
双层压缩减压 (DLD) 具有显著更长的操作时间 (P < 0.001),没有增加并发症或重新操作.

结论:

单级MIS减压对于症状单级狭窄和相邻水平狭窄的LSS患者来说,同双级减压一样有效.
额外的操作时间和DLD的潜在风险可能在具有同等结果的情况下是不合理的.
在这种患者群体中,仅仅减压症状水平似乎就足够了.

关键词:

在MIS下压缩解压.这是一项双层次的外科手术.腰椎脊柱狭窄症腰椎脊柱狭窄症单一水平的外科手术.

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