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- 검색키워드
- 주제어 : Microscopic spinal decompression (검색결과 3 건)
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Zechuan Yang,Huan Wang,Wenkai Li,Weihua Hu 대한척추신경외과학회 2022 Neurospine Vol.19 No.4
Objective: This meta-analysis with statistical power analysis aimed to evaluate the difference between full-endoscopic and microscopic spinal decompression in treating spinal stenosis. Methods: We searched PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and CNKI (China National Knowledge Infrastructure) for relevant randomized controlled trials (RCTs) regarding the comparison of full-endoscopic versus microscopic spinal decompression in treating lumbar spinal stenosis through February 28, 2022. Two independent investigators selected studies, extracted information, and appraised methodological quality. Meta-analysis was conducted using RevMan 5.4 and STATA 14.0, and statistical power analysis was performed using G*Power 3.1. Results: Six RCTs involving 646 patients met selection criteria. Meta-analysis suggested that, compared with microscopic decompression, full-endoscopic spinal decompression achieved more leg pain improvement (mean difference [MD], -0.20; 95% confidence interval [CI], -0.30 to -0.10; p = 0.001), shortened operative time (MD, -12.71; 95% CI, -18.27 to -7.15; p < 0.001), and decreased the incidence of complications (risk ratio, 0.43; 95% CI, 0.22–0.82; p = 0.01), which was supported by a statistical power of 98.57%, 99.97%, and 81.88%, respectively. Conclusion: Full-endoscopic spinal decompression is a better treatment for lumbar spinal stenosis, showing more effective leg pain improvement, shorter operative time, and fewer complications than microscopic decompression.
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Junjie Li,Jiheng Yin,Jun Liu,haixiong Lin,Haifeng Yuan 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.2
This study aimed to compare the safety and effectiveness between unilateral biportal endoscopy (UBE) technique and microscopic decompression (MD) technique in lumbar spinal stenosis treatment. PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, and other databases were used to conduct extensive literature searches. RevMan ver. 5.3 software was used for the statistical analysis. Eleven studies were included with 930 patients, including 449 patients in the UBE group and 521 in the MD group. Both techniques revealed similar operative times at −1.77 minutes (95% confidence interval [CI], −7.59 to 4.05 minutes; p =0.55), the postoperative dural expansion area at −1.27 (95% CI, −19.30 to 16.77; p =0.89), the postoperative complications at 0.76 (95% CI, 0.47 to 1.22; p =0.26), the preoperative Visual Analog Scale (VAS) for leg pain, and the last follow-up (>12 months) VAS for leg pain at −0.04 (95% CI, −0.14 to 0.06; p =0.47), the preoperative Oswestry Disability Index (ODI), and the last follow-up (>12 months) ODI scores at −0.18 (95% CI, −0.76 to 0.40; p =0.54), and patient satisfaction (the modified MacNab score) at 1.15 (95% CI, 0.54 to 2.42; p =0.72). However, intraoperative bleeding was lower following the UBE technique at −52.78 mL (95% CI, −93.47 to −12.08 mL; p =0.01) and was shorter following the UBE technique at −3.06 (95% CI, −3.84 to −2.28; p <0.01). UBE and MD technology have no significant differences in efficacy or safety in the treatment of patients with lumbar spinal stenosis based on this meta-analysis. However, the UBE technique has less intraoperative bleeding and a shorter hospital stay. It has a slight advantage and is a better surgical option than the MD technique. It can be an alternative minimally invasive spinal surgery method.
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수술현미경하에서 제한적 추궁절제술을 시행한 요추관 협착증 환자의 임상적 고찰
이남영,김관태,염진영,김성호,송시헌,김윤 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.7
The cases of twenty-eight patients with spinal stenosis treated by microscopic decompressive surgery from January 1991 to September 1995 were analysed in an attempt to define Its clinical feature and to evaluate the results of our modified operation technique of preventing postoprative spinal instability The main age group of the patients were In the fifties and sixties. On plain X-ray most lumbar spine of the patients showed degenerative change Pain in lower back and legs were the most common symptom. and intermittent neurogenic claudication was presented in three quaters of the patients Radiologically the diagnosis was confirmed by either myelography. CT and MRI of by their combination The major etiologic factors were thickening of ligamentum flavum hypertrophy of laminae of facet joints and associated herniated nucleus pulposus. Since a significant rate of postdecompressive instability had been reported by other authors therefore we have decided to performed less extensive decompressive total laminectomy procedure. The outcome of our decompressive laminectomy was favorable In patients with no preoperative instability newly developed instability following the less extensive decompressive total laminectomy was none
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