Guang Hua Li, Zenya Ito, Motohide Shibayama, Shu Nakamura, LiGuo Zhu, Fujio Ito
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引用次数: 0
Abstract
Background: Unilateral biportal endoscopic laminotomy (UBE) and percutaneous endoscopic laminotomy (PEL) are minimally invasive spinal surgery (MISS) techniques used for unilateral and dual-channel endoscopic laminectomy. However, limited research has been conducted on lumbosacral multifidus muscle injuries in elderly individuals undergoing MISS for lumbar spinal canal stenosis. The objective of this study was to investigate the impact of single-channel and double-channel MISS on the multifidus muscle in elderly patients.
Materials and methods: A total of 107 patients who underwent MISS were stratified into two cohorts: group A (<65 years) and group B (≥65 years). Preoperative imaging data, including magnetic resonance imaging, were gathered to classify the degree of stenosis based on the nerve root compression. The extent of multifidus muscle atrophy and fat infiltration was assessed by calculating the fat-free cross-sectional area (FCSA)/cross-sectional area (CSA) ratio before and after surgery through measurements of CSA and FCSA. Total cross-sectional area/FCSA were calculated using MRI cross-sectional T2WI.
Results: The degree of atrophy and fat infiltration did not change between procedures in group A (P>.05), but changed significantly in group B (P<.05).
Conclusion: Unilateral single-channel and double-channel surgery had no significant effect on the degree of multifidus muscle atrophy and fat infiltration in patients younger than 65 years. However, in patients 65 years and older, the degree of multifidus muscle atrophy and fat infiltration significantly increased with the increasing incidence of lateral recess stenosis, which was positively correlated with the duration of surgery. [Orthopedics. 202x;4x(x):xx-xx.].
背景：单侧双通道内窥镜椎板切除术（UBE）和经皮内窥镜椎板切除术（PEL）是用于单侧和双通道内窥镜椎板切除术的微创脊柱手术（MISS）技术。然而，关于老年人接受腰椎管狭窄症微创手术时腰骶部多裂肌损伤的研究还很有限。本研究旨在探讨单通道和双通道 MISS 对老年患者腰骶部多裂肌的影响：共 107 名接受 MISS 的患者被分为两组：A 组（结果：A 组患者的多裂肌萎缩程度和脂肪浸润程度明显低于 B 组）；B 组（结果：B 组患者的多裂肌萎缩程度和脂肪浸润程度明显低于 C 组）：A组患者的萎缩程度和脂肪浸润程度在不同手术中没有变化（P>.05），但B组有显著变化（PC结论：单侧单通道和双通道手术对 65 岁以下患者的多裂肌萎缩和脂肪浸润程度没有明显影响。然而，在 65 岁及以上的患者中，多裂肌萎缩和脂肪浸润程度随着侧凹狭窄发生率的增加而明显增加，这与手术时间的长短呈正相关。[骨科。202x;4x(x):xx-xx]。
期刊介绍：
For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice.
The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.
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