在拉米切除术后腰椎退化的进展
Kunihiko Hashimoto1, Kazuma Kitaguchi1,2, Daisuke Tateiwa1
1Department of Orthopedic Surgery, Spine and Spinal Cord Center, Osaka International Medical and Science Center, Osaka, JPN.
Cureus
|January 22, 2025
概括
细叶切除术后退行性腰椎脊髓疾病的进展并不常见,但可能发生. 与其他减压手术相比,腰椎脊椎过程分裂膜切除术 (LSPSL) 的进展和重新手术率降低.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 脊柱疾病 脊柱疾病
背景情况:
- 腰椎道狭窄 (LCS) 是一种流行的退行性腰椎脊髓疾病 (DLSD).
- 减压手术 (细膜切除术) 是DLSD的常见治疗方法.
- 观察到需要重新手术的DLSD的术后进展,但很少被研究.
研究的目的:
- 为了调查DLSD在拉美切除术后进展的发生率和风险因素.
- 为了比较不同层切除术技术在疾病进展和重复手术率方面的结果.
主要方法:
- 一项对247名患者 (平均年龄73.3岁) 的回顾性研究,这些患者接受了减压手术.
- 手术技术包括双边局部切除膜切除术 (BPL),腰椎脊椎过程分裂切除膜切除术 (LSPSL) 和微内镜切除膜切除术 (MEL).
- 随访平均为2.3年,评估症状进展,重新手术和滑动进展.
主要成果:
- 13.8%的患者出现症状进展,3.6%需要重新手术,大多在一年内.
- 在患有甲状腺狭窄症的患者中,复手率更高.
- 35名患者 (14.2%) 显示滑动进展;LSPSL显示滑动进展显著减少.
- 脊柱通道和前狭窄与滑动进展有关.
结论:
- 腰椎脊椎过程分裂膜切除术 (LSPSL) 与运河和前狭窄症的发病率降低有关.
- 症状DLSD进展在手术后的第一年内更为频繁.
- 前狭窄是需要重新手术的关键因素.
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