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  • Title: [Short-term effectiveness of accurate decompression via foraminoplasty in treatment of lumbar lateral recess stenosis].
    Author: Wang Y, Kong Q, Song Y.
    Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2017 Nov 15; 31(11):1334-1340. PubMed ID: 29798587.
    Abstract:
    OBJECTIVE: To discuss the effectiveness and the safety of accurate decompression via foraminoplasty in treating lumbar lateral recess stenosis patients who accompanied by disk-flavum ligamentum space and bony lateral recess stenosis, and to analysis the short-term effectiveness of the surgical procedures. METHODS: Forty-five lumbar lateral recess stenosis patients accompanied by disk-flavum ligamentum space and bony lateral recess stenosis were treated by accurate decompression via foraminoplasty between January 2013 and January 2016. There were 29 males and 16 females with a median age of 58 years (range, 42-82 years). The disease duration was 3-96 months (mean, 24.4 months). The lesion segment included L 4, 5 in 36 cases and L 5, S 1 in 9 cases. The visual analogue scale (VAS) score of low back pain and leg pain at preoperation and last follow-up were recorded, and the modified Macnab criteria was used to evaluate the effectiveness at last follow-up. Postoperative CT and MRI were reviewed to evaluate the stability and decompression of the lumbar spine. RESULTS: All operations were successfully completed. All the 45 patients were followed up 3-18 months (median, 11 months). Dural tear occurred in 2 cases during operation, bone graft removed into the spinal canal in 1 case, postoperative low back pain occurred in 5 cases, and there was no nerve root injury, hematoma formation, or other complications. The leg pain VAS score at last follow-up (0.6±1.2) was significantly improved when compared with preoperative score (5.7±1.4) ( t=8.981, P=0.001); and the low back pain VAS scores showed no significant difference between preoperation and last follow-up (1.5±1.3 vs. 1.7±1.4; t=0.535, P=0.585). According to the modified Macnab criteria, the results were excellent in 20 cases, good in 22 cases, fair in 2 cases, and poor in 1 case at last follow-up, and the excellent and good rate was 93.3%. CONCLUSION: Accurate decompression via foraminoplasty is an effective, safe, and less invasive way for treating lumbar recess stenosis patients accompanied by disk-flavum ligamentum space and bony lateral recess stenosis. 目的: 探讨精准椎间孔成形减压术治疗同时伴有盘黄间隙狭窄和骨性侧隐窝狭窄的腰椎侧隐窝狭窄症患者的有效性及安全性，并分析其近期临床疗效。. 方法: 回顾分析 2013 年 1 月—2016 年 1 月收治并采用精准椎间孔成形减压术治疗的 45 例伴有盘黄间隙狭窄和骨性侧隐窝狭窄的腰椎侧隐窝狭窄患者临床资料。其中男 29 例，女 16 例；年龄 42～82 岁，中位年龄 58 岁。病程 3～96 个月，平均 24.4 个月。病变节段：L 4、5 36 例，L 5、S 1 9 例。记录术前及末次随访时患者腰痛与腿痛疼痛视觉模拟评分（VAS），末次随访时采用改良 Macnab 标准评估手术疗效。术后复查 CT 及 MRI，评价术后腰椎稳定性及减压情况。. 结果: 所有手术均顺利完成。45 例均获随访，随访时间 3～18 个月，中位时间 11 个月。2 例术中出现硬膜囊撕裂，1 例切除骨块移至椎管内，5 例出现术后腰背痛，无神经根损伤、血肿形成等并发症发生。末次随访时患者腿痛 VAS 评分为（0.6±1.2）分，较术前的（5.7±1.4）分显著改善（ t=8.981， P=0.001）；腰痛 VAS 评分为（1.7±1.4）分，与术前的（1.5±1.3）分比较差异无统计学意义（ t=0.535， P=0.585）。末次随访时根据改良 Macnab 标准评价疗效，优 20 例，良 22 例，可 2 例，差 1 例，优良率 93.3%。. 结论: 精准椎间孔成形减压术是一种治疗同时伴有盘黄间隙及骨性侧隐窝狭窄的侧隐窝型腰椎管狭窄症患者的微创、有效、安全的手术方式。.
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