【摘要】 [目的]比较Endo-Surgi Plus脊柱内镜单侧入路双侧减压技术（endoscopic unilateral laminotomy and bilateral decompression, Endo-ULBD）与开放双侧减压治疗老年腰椎管狭窄症患者的临床疗效。[方法] 2018年12月—2020年12月在本院手术治疗的51例腰椎管狭窄症患者纳入本研究，根据医患沟通结果，将患者分为内镜组（31例），开放组（20例）。比较两组临床和影像结果。[结果]所有患者均顺利完成手术，内镜组手术时间[(73.2±21.0) min vs (178.4±22.9) min, P<0.001]、术中出血量[(7.1±3.6) ml vs (220.0±140.9) ml, P<0.001]、术后下地时间[(1.5±0.4) d vs (6.4±1.8) d, P<0.001]、住院时间[(3.0±1.2) d vs (9.4±3.1) d,P<0.001]均显著少于开放组。随时间推移，两组腰痛、腿痛VAS评分、ODI评分均显著改善（P<0.05），相应时间点，两组间上述指标的差异均无统计学意义（P>0.05）。末次随访两组MacNab优良率的差异无统计学意义（P>0.05）。与术前相比，末次随访时，两组椎间隙高度无显著变化（P>0.05），硬膜囊横截面积显著增加（P<0.05）。相应时间点，两组间上述影像指标的差异均无统计学意义（P>0.05）。[结论] Endo-ULBD治疗老年腰椎管狭窄症，具有安全、微创、康复快等优点，且疗效与开放手术相当，短期临床疗效好。更多还原

【Abstract】 [Objective] To compare the clinical outcomes of endoscopic unilateral laminotomy and bilateral decompression(EndoULBD) with Endo-Surgi Plus endoscope versus open bilateral decompression for lumbar spinal stenosis in the elderly. [Methods] A retrospective study was done on 51 patients who received surgical treatment for lumbar spinal stenosis in our hospital from December 2018 to December 2020. According to the doctor-patient communication, 31 patients underwent the endoscopic decompression, while other 20 patients had the conventional open decompression. The clinical and imaging data were compared between the two groups. [Results] All patients in both groups had operation performed successfully. The endoscopic group was significantly superior to the open group in terms of operation time [(73.2±21.0) min vs(178.4±22.9) min, P<0.001], intraoperative blood loss [(7.1±3.6) ml vs(220.0±140.9) ml, P<0.001], postoperative bed rest time [(1.5±0.4) days vs(6.4±1.8) days, P<0.001], and hospital stay [(3.0±1.2) days vs(9.4±3.1) days, P<0.001]. As time went by, the VAS scores of low back pain and leg pain, as well as ODI score in the two groups were significantly improved(P<0.05), which were not statistically significant between the two groups at any corresponding time points(P>0.05). At the last follow-up, there was no significant difference in MacNab excellent and good rate between the two groups(P>0.05). At the last follow-up, there was no significant change in vertebral space height(P>0.05), while the dural sac cross-sectional area was significantly increased in both groups compared with those before operation(P<0.05). At corresponding time points, there were no significant differences in the above image indicators between the two groups(P>0.05). [Conclusion] The Endo-ULBD achieve good short-term clinical consequence comparable to the open surgery, while has the advantages of minimally invasive surgery and rapid recovery for lumbar spinal stenosis in the elderly.更多还原