椎间孔镜治疗腰椎管狭窄的效果及并发症影响因素

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[中图分类号]R619；R681.5 [文献标志码]A [文章编号] 2096-5532（2025）04-0613-05

doi：10.11712/jms.2096-5532.2025.61.132

[Abstract]ObjectiveToinvestigatetheeficacyof minimallyinvasivetransforaminal endoscopic decompression（MITED） forthetreatmentofsingle-leveldegenerativelumbarspinalstenosis（SL-DLSS），andtoanalyzecomplications-relatedinfluencing factors.MethodsWe included160 patients whounderwent MITED treatment for SL-DLSS，with postoperativecomplications presentin32casesandabsentin128cases.ThefactorsaffectingtheoccurrenceofcomplicationsafterMITEDweredetermined throughabinarylogisticregressionanalysis，andtheirpredictivevaluewasasessed.ResultsAt7dandlyearpostoperatively， thepatients experienced significantreductionsinthevisualanalogue scale（VAS）scoresofleg pain，VASscoresoflowback pain， and Oswestry Disability Index（ODI） scores .The binary logistic regression analysis showed thatage，thenumberofcomplications，operative time，preoperativelowback pain VASscore，and preoperativeODI score were significant factors influencing the occurrence of complications after MITED for SL-DLSS OR=1.132-4.984，P<0.05 ： Usingage，the numberof complications，operative time，preoperativelow back pain VAS score，and preoperative ODI score to predicttheoccurrenceofcomplicationsafter MITEDforSL-DLSS，theareasunder thereceiveroperating characteristiccurves （AUCs）were 0.828，0.757，0.873，0.749，and O.761，respectively；the sensitivities were 62.5% ， 93.8% ， 78.1% ， 71.9% ，and 40.6% ，respectively；the specificities were 96.1% ， 46.1% ， 93.0% ， 85.9% ，and 99.2% ，respectively. Incorporating the independentinfluencingfactorsinaregressonmodelforpredictingtheourrenceofcomplicationsafterMITEDforSL-DLSS，theAUC was O.960，with its sensitivity and specificity being 93.8% and 89.1% .ConclusionMITED is effective in relieving pain and improving lumbarspinefunctioninpatients withSL-DLSS，anditsriskofcomplications isafectedbyage，comorbidities，operative time，and preoperative VAS and ODI scores.The prediction model based on these factors demonstrates good predictive value.

[Key words]lumbar vertebrae；spinal stenosis；intervertebral disc degeneration；percutaneous endoscopic lumbar discecto my；postoperative complications；forecasting

腰椎管狭窄症是因腰椎管空间减小压迫神经结构，引发腰背及下肢疼痛、麻木等症状的退行性疾病[1-2]。（剩余6919字）