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1.
Chinese Journal of Orthopaedics ; (12): 755-765, 2019.
Article in Chinese | WPRIM | ID: wpr-755215

ABSTRACT

Objective To compare the clinical effects of endoscopic laminectomy with traditional hemilaminectomy for lumbar spinal stenosis. Methods From January 2016 to April 2017, 61 patients with lumbar spinal stenosis were treated surgi?cally. Percutaneous endoscopic laminectomy was performed in 32 patients (minimally invasive group), including 13 males and 19 females, aged 38-76 years, with an average age of 58.47±7.51 years. Twenty?nine patients (open group) underwent hemilaminecto?my, including 11 males and 18 females, aged 38-75 years, with an average age of 57.17±9.99 years. The operation time, bleeding, incision length, bedridden time and hospitalization time were recorded. Visual analogue scale(VAS), Oswestry disability index (ODI), dural sac cross?sectional area (DSCA), ventral intervertebral space height (VH), dorsal intervertebral space height (DH) and lumbar mobility (range of motion, ROM) were compared between the two groups. Results All of 61 patients were followed up for 14 to 27 months, with an average of 19.2±2.95 months. The operation time was 60.88±6.49 min in the minimally invasive group, and 52.07±9.45 min in the open group (t=4.277, P=0.000). The blood loss of minimally invasive group was 55.63±10.14 ml, and that of open group was 78.79±12.58 ml (t=7.952, P=0.000). The incision length of minimally invasive group was 23.31±4.56 mm, and open group 82.59±7.66 mm (t=12.047, P=0.000). Bed rest time was 21.97±6.42 h in minimally invasive group and 78.79± 12.58 h in open group (t=12.047, P=0.000). The hospitalization time of the minimally invasive group was 8.53±2.75 d and the open group 11.34±3.12 d (t=3.745, P=0.000). All these parameters had statistical significance (P<0.05). At the last follow?up, the VAS score of minimally invasive group was 1.06±0.56, and the open group was 1.14±0.74 (t=0.469,P=0.634). ROM of open group was 5.66±1.12 degree, and ROM of minimally invasive group was 5.56±1.13 degree (t=0.140, P=0.710), VH of minimally invasive group was 14.75±2.81 mm, and open group was 14.44±2.89 mm (t=0.181, P=0.672). There was no significant difference between the two groups for these parameters. At the last follow?up, ODI score was 13.25%±1.08% in the minimally invasive group and 14.28% ± 2.10% in open group (t=5.911, P=0.018). DSCA score was 108.56 ± 8.69 mm2 in the minimally invasive group, and 117.28±11.09 mm2 in open group (t=11.774, P=0.001). There were significant differences between the two groups for ODI and DS?CA. Conclusion Both endoscopic and open laminectomy have excellent clinical effects on lumbar spinal stenosis. Endoscop?ic laminectomy has the advantages of less local trauma, less damage to the stability of the lumbar spine and faster recovery. However, there's a higher technical requirement for endoscopic spine surgery.

2.
Chinese Journal of Orthopaedics ; (12): 755-765, 2019.
Article in Chinese | WPRIM | ID: wpr-800547

ABSTRACT

Objective@#To compare the clinical effects of endoscopic laminectomy with traditional hemilaminectomy for lumbar spinal stenosis.@*Methods@#From January 2016 to April 2017, 61 patients with lumbar spinal stenosis were treated surgi-cally. Percutaneous endoscopic laminectomy was performed in 32 patients (minimally invasive group), including 13 males and 19 females, aged 38-76 years, with an average age of 58.47±7.51 years. Twenty-nine patients (open group) underwent hemilaminecto-my, including 11 males and 18 females, aged 38-75 years, with an average age of 57.17±9.99 years. The operation time, bleeding, incision length, bedridden time and hospitalization time were recorded. Visual analogue scale(VAS), Oswestry disability index (ODI), dural sac cross-sectional area (DSCA), ventral intervertebral space height (VH), dorsal intervertebral space height (DH) and lumbar mobility (range of motion, ROM) were compared between the two groups.@*Results@#All of 61 patients were followed up for 14 to 27 months, with an average of 19.2±2.95 months. The operation time was 60.88±6.49 min in the minimally invasive group, and 52.07±9.45 min in the open group (t=4.277, P=0.000). The blood loss of minimally invasive group was 55.63±10.14 ml, and that of open group was 78.79±12.58 ml (t=7.952, P=0.000). The incision length of minimally invasive group was 23.31±4.56 mm, and open group 82.59±7.66 mm (t=12.047, P=0.000). Bed rest time was 21.97±6.42 h in minimally invasive group and 78.79±12.58 h in open group (t=12.047, P=0.000). The hospitalization time of the minimally invasive group was 8.53±2.75 d and the open group 11.34±3.12 d (t=3.745, P=0.000). All these parameters had statistical significance (P<0.05). At the last follow-up, the VAS score of minimally invasive group was 1.06±0.56, and the open group was 1.14±0.74 (t=0.469, P=0.634). ROM of open group was 5.66±1.12 degree, and ROM of minimally invasive group was 5.56±1.13 degree (t=0.140, P=0.710), VH of minimally invasive group was 14.75±2.81 mm, and open group was 14.44±2.89 mm (t=0.181, P=0.672). There was no significant difference between the two groups for these parameters. At the last follow-up, ODI score was 13.25%±1.08% in the minimally invasive group and 14.28%±2.10% in open group (t=5.911, P=0.018). DSCA score was 108.56±8.69 mm2 in the minimally invasive group, and 117.28±11.09 mm2 in open group (t=11.774, P=0.001). There were significant differences between the two groups for ODI and DS-CA.@*Conclusion@#Both endoscopic and open laminectomy have excellent clinical effects on lumbar spinal stenosis. Endoscop-ic laminectomy has the advantages of less local trauma, less damage to the stability of the lumbar spine and faster recovery. However, there's a higher technical requirement for endoscopic spine surgery.

3.
Article in Chinese | WPRIM | ID: wpr-528696

ABSTRACT

0.05).Traction reactions,the use of sedative and centrally acting anesthesia drugs during the operation were significantly less in group AEA than those in group EA(P

4.
Article in Chinese | WPRIM | ID: wpr-554535

ABSTRACT

AIM: To observe the effect of small dose ephedrine on hypote ns ion as the lithotomy position in laying down legs after the aged in the operatio ns with epidural anesthesia. METHODS: Twenty-seven ASA Ⅰ-Ⅱma le patients, aged 65-83 (71? 6.5 ) years undergoing transurethral resection of prostate (TURP) with the lithotomy position were randomly assigned to two gro ups by double blind method: ephedrine group (n=13) and contrasti ve group (n=14). The continual epidural anesthesia was administe red in T 12 -L 1 and L 3-4 for all patients used 1.5 % lidocaine. W hen the operation was finished off, before thirty seconds of horizontal position laying down legs, 15 mg ephedrine was iv at ephedrine group and 3 ml saline wat er at control group. After legs were laid down on the lithotomy position, variab les of SBP, MBP and P were recorded in ten minutes. RESULTS: Dur ing ten minutes after double legs were laid down, the variables were lightly ris en about 8.7 % to 76.9 % in ephedrine group and were fallen about 7.8 % to 85.7 % in control group. The difference on variables of two groups was significant (P

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