电磁导航引导经皮椎间孔镜治疗退变性腰椎管狭窄症的临床研究

doi:10.13418/j.issn.1001-165x.2022.4.16

中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (4): 460-465.doi: 10.13418/j.issn.1001-165x.2022.4.16

电磁导航引导经皮椎间孔镜治疗退变性腰椎管狭窄症的临床研究

陈波涛，樊效鸿*，陈日高，余洋，蒋雷明，李黔春

成都中医药大学附属医院，四川省中医院骨科，成都 610075

收稿日期:2020-10-25 出版日期:2022-07-25 发布日期:2022-07-26
通讯作者: 樊效鸿，博士，教授，主任医师，E-mail：fanxiaohong @cdutcm.edu.cn
作者简介:陈波涛（1980-）男，重庆人，博士研究生，副主任医师，脊柱外科，E-mail：271114988@qq.com
基金资助:
四川省重大科技专项课题（2018SZDZX0013）

Clinical study of degenerative lumbar spinal stenosis with percutaneous endoscopic guided by electromagnetic navigation

Chen Botao, Fan Xiaohong*, Chen Rigao, Yu Yang, Jiang Leiming, Li Qianchun

Department of Orthopedics, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine/Sichuan Provincial Hospital of Traditional Chinese Medicine, Chengdu 610075, China

Received:2020-10-25 Online:2022-07-25 Published:2022-07-26

摘要/Abstract

摘要： 目的观察电磁导航引导经皮椎间孔镜治疗退变性腰椎管狭窄症的临床效果。方法采取回顾性队列研究。收集我院骨科2018年9月~2019年9月椎间孔镜治疗的退变性腰椎管狭窄症患者63例，分为导航组（27例）和常规组（36例）。记录两组人口学特征及手术相关指标，采用VAS、JOA评分评价临床疗效。结果两组人口学和术前临床特征比较，差异无统计学意义（P>0.05）。两组术中透视次数、穿刺及手术时间、术后住院时间比较，差异有统计学意义（P<0.05），腿痛VAS评分、JOA评分组内比较，差异有统计学意义（P<0.05）。两组术后复发率比较，差异无统计学意义（P>0.05）。结论电磁导航引导经皮椎间孔镜治疗腰椎管狭窄症，可以减少透视次数、穿刺和手术时间、术后住院时间，降低术中辐射暴露，提升穿刺定位效率。

关键词: 腰椎； , , 椎管狭窄； , , 椎间盘切除术； , , 内窥镜； , , 导航

Abstract: Objective To explore the clinical application value of degenerative lumbar spinal stenosis through the intervertebral foramen with percutaneous endoscopic guided by electromagnetic navigation. Methods A retrospective cohort study was performed. From Sep 2018 to Sep 2019, 63 patients with degenerative lumbar spinal stenosis were treated with percutaneous endoscopic, who were divided into a navigation group (n=27) and a conventional group (n=36). The demographic characteristics and operation-related indexes of the two groups were recorded. Visual analog scale (VAS) and Japanese Orthopedic Association scores (JOA) were used to evaluate and analyze the clinical efficacy. Results There was no significant difference in the demographic characteristics and preoperative clinical features between the two groups (P>0.05). There were significant differences in fluoroscopy times, puncture and operation time, postoperative hospital stays between the two group (P<0.05), and there were significant differences in VAS score and JOA score of leg pain preoperative and postoperative in each group (P<0.05). There was no significant difference in the recurrence rate between the two groups (P>0.05). Conclusions Percutaneous endoscopic treatment of lumbar spinal stenosis guided by electromagnetic navigation can reduce the fluoroscopy times, puncture and operation time, postoperative hospital stays, thus reducing the radiation exposure during operation and improving the efficiency of positioning and punctruing.

Key words: Lumbar spine; , , Spinal stenosis; , , Discectomy; , , Navigation, Endoscope

中图分类号:

R681.55

陈波涛, 樊效鸿, 陈日高, 余洋, 蒋雷明, 李黔春. 电磁导航引导经皮椎间孔镜治疗退变性腰椎管狭窄症的临床研究[J]. 中国临床解剖学杂志, 2022, 40(4): 460-465.

Chen Botao, Fan Xiaohong, Chen Rigao, Yu Yang, Jiang Leiming, Li Qianchun. Clinical study of degenerative lumbar spinal stenosis with percutaneous endoscopic guided by electromagnetic navigation[J]. Chinese Journal of Clinical Anatomy, 2022, 40(4): 460-465.

参考文献

[1] Hoogland T, Schubert M, Miklitz B, et al. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases[J]. Spine(Phila Pa 1976), 2006, 31(24): E890-E897. DOI: 10.1097/01.brs.0000245955.22358.3a.
[2] Ahn Y, Lee S, Son S, et al. Learning curve for transforaminal percutaneous endoscopic lumbar discectomy: a systematic review[J]. World Neurosurg, 2020, 143:471-479. DOI: 10.1016/j.wneu. 2020. 08.044.
[3] Fan GX, Han RA, Gu X, et al. Navigation improves the learning curve of transforaminal percutaneous endoscopic lumbar discectomy[J]. Int Orthop, 2017, 41(2): 323-332. DOI: 10.1007/s00264-016-3281-5.
[4] 周跃, 李长青, 王建, 等. 椎间孔镜YESS与TESSYS技术治疗腰椎间盘突出症[J]. 中华骨科杂志, 2010, 30(3): 225-231. DOI: 10.3760/cma.j.issn.0253-2352.2010.03.001.
[5] Li X, Hu Z, Cui J, et al. Percutaneous endoscopic lumbar discectomy for recurrent lumbar disc herniation[J]. Int J Surg, 2016, 27(1): 8-16. DOI: 10.1016/j.ijsu.2016.01.034.
[6] 范永飞, 刘刚. 脊柱微创手术中患者辐射暴露和应对措施的研究进展[J]. 中国脊柱脊髓杂志, 2018, 28(11): 1042-1045. DOI: 10.3969/j.issn.1004-406X.2018.11.12.
[7] 孙振兴, 王贵怀, 王劲. 手术导航在脊髓脊柱疾病中的应用进展[J]. 中华神经外科杂志, 2018, 34(5): 534-537. DOI: 10.3760/cma.j.issn.1001-2346.2018.05.024.
[8] 蒋翔, 徐峰. 磁力导航结合CT三维成像系统在胸腰椎经皮椎弓根螺钉置入术中的临床应用[J]. 中国脊柱脊髓杂志, 2020, 30(1): 86-90. DOI: 10.3969/j.issn.1004-406X.2020.01.13.
[9] 管敏武, 严玉金, 陈凌. 导航联合内镜辅助远外侧入路的解剖学研究[J]. 中国临床解剖学杂志,2018, 36(1): 1-4. DOI: 10.13418/j.issn. 1001-165x.2018.01.001.
[10] Schizas C, Theumann N, Burn A, et al. Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images[J]. Spine (Phila Pa 1976), 2010, 35(21): 1919-1924. DOI: 10.1097/BRS.0b013e3181d359bd.
[11] Lee GY, Lee JW, Choi HS, et al. A new grading system of lumbar central canal stenosis on MRI: an easy and reliable method[J]. Skeletal Radiol, 2011, 40(8): 1033-1039. DOI: 10.1007/s00256-011-1102-x.
[12] Wu RH, Liao XQ, Xia H. Radiation exposure to the surgeon during ultrasound-assisted transforaminal percutaneous endoscopic lumbar discectomy: a prospective study[J]. World Neurosurg, 2017, 101(3): 658-665. DOI: 10.1016/j.wneu.2017.03.050.
[13] Lee JH, Jeon GR, Ro JH, et al. Evaluation of an experimentally designed stereotactic guidance system for determining needle entry point during uniplanar fluoroscopy-guided Intervention[J]. Korean J Pain, 2012, 25(2): 81-88. DOI: 10.3344/kjp.2012.25.2.81.
[14] 谭海涛, 黄圣斌, 谢兆林, 等. 导航导杆在椎间孔镜穿刺定位的应用[J]. 中国脊柱脊髓杂志, 2017, 27(4): 339-344. DOI: 10.3969/j.issn.1004-406X.2017.04.08.
[15] 朱慧阳, 叶斌, 段伟, 等. 术前三维影像测量结合激光导航器引导下穿刺行经椎间孔入路经皮内窥镜下椎间盘切除术[J]. 脊柱外科杂志, 2019, 17(1): 11-17. DOI: 10.3969/j.issn.1672-2957.2019.01.003.
[16] 许波. 超声容积导航定位腰椎间孔下椎间孔镜技术的临床应用研究[J]. 影像研究与医学应用, 2017, 1(5): 151-152. DOI: 10.3969/j.issn.2096-3807.2017.05.097.
[17] 杨军, 杨群, 王博, 等. 基于3D打印技术构建个体化椎间孔镜穿刺导向器的设计与应用[J]. 中国组织工程研究, 2018, 840(19): 3055-3060. DOI: 10.3969/j.issn.2095-4344.0791.
[18] 张愈峰. 3D打印导航板在椎间孔镜下腰椎髓核摘除术中的临床应用[J]. 中国脊柱脊髓杂志, 2019, 29(5): 444-448. DOI: 10.3969/j.issn.1004-406X.2019.05.09.
[19] 唐春, 姜彦, 杨先. 电磁导航及内镜技术在眼眶异物摘出术中的作用[J]. 中华眼外伤职业眼病杂志, 2018, 40(2): 97-100. DOI: 10.3760/cma.j.issn.2095-1477.2018.02.005.
[20] 张俊杰, 马士崟, 李慧, 等. 电磁导航技术在鼻颅底手术中的应用[J]. 中国耳鼻咽喉颅底外科杂志, 2019, 25(6): 630-634. DOI: 10.11798/j.issn.1007-1520.201906012.
[21] Qian K, Krimsky WS, Sarkar SA, et al. Efficiency of electromagnetic navigation bronchoscopy and virtual rronchoscopic navigation[J]. Ann Thorac Surg, 2020, 109(6): 1731-1740. DOI: 10.1016/j.athoracsur.2020.01.019.
[22] 郭振宇, 黄廷钦, 周任, 等. 电磁导航技术在神经内镜下血肿清除术中的应用[J]. 中华神经医学杂志, 2020, 19(5): 477-482. DOI: 10.3760/cma.j. cn115354-20200102-00001.

电磁导航引导经皮椎间孔镜治疗退变性腰椎管狭窄症的临床研究

Clinical study of degenerative lumbar spinal stenosis with percutaneous endoscopic guided by electromagnetic navigation

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