Treatment of degenerative lumbar spine stenosis by modified unilateral approach for bilateral decompression under microendoscope
10.3969/j.issn.1004-406X.2010.01.04
- VernacularTitle:显微内窥镜下改良工作通道单侧入路双侧减压治疗退变性腰椎管狭窄症
- Author:
Qingchu LI
;
Huilin HU
;
Yuan YANG
- Publication Type:Journal Article
- Keywords:
Lumbar vertebrae;
Spine stenosis;
Microendoscope;
Modified channel
- From:
Chinese Journal of Spine and Spinal Cord
2010;20(1):15-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility and clinical efficacy of the treatment of lumbar spine steno-sis by modified unilateral approach for bilateral decompression under microendoscope.Method:217 cases with degenerative lumbar spine stenosis from September 2003 to December 2008 were treated by modified unilater-al approach for bilateral decompression of central spinal canal and nerve root canal under microendoscope.A-mong them laminectomy of one segment was done in 163 cases,two segments were done in 54 cases.After surgery,the routine radiograph were carried out and the Nakai criterion was used for assessment.Result:The mean operative time was 48±13min (range,25 to 95min),the average blood loss was 37±9ml (range,25 to 180ml),the average skin incision length was 2.2±0.2cm(1.8 to 2.4cm).2 cases had dural matter tearing,which healed after filling with gelatin foam and 2 weeks bed rest,after that no cerebrospinal fluid leakage was noted after surgery.Mislocation was noted in 1 case.No nerve inury and postoperative infection oceurred.Postoperative CT scan demonstrated complete decompression of the central spinal canal and nerve root canal.All patients were followed-up for an average of 14 months (range,3 months to 24 months).The Nakai criterion at final follow-up showed clinical excellent in 134 cases,good in 63 cases,fair in 16 cases and worse in 4 cases, with the excellent and good rate of 90.8%.No lumbar spine instability was noted.Conclusion:Treatment of de-generative lumbar spine stenosis by modified unilateral approach for bilateral decompression under mieroendo-scope has the merit of minimal invasive,less complications and reliable therapeutical effect.
