探讨经皮脊柱内镜下可视化环锯单侧入路双侧减压治疗腰椎管狭窄症的可行性及疗效。

2015年9月至2017年9月采用经皮脊柱内镜下利用可视化环锯经单侧入路完成腰椎管狭窄的双侧减压31例。记录手术时间、术中出血量，术后并发症发生情况及CT复查的表现等，并对患者于末次随访时按Nakai标准评定疗效，并计算优良率。

手术时间65~125 min，平均（48±13）min；术中出血25~180 ml，平均（37±9）ml；切口约7~8 mm，平均（7.0±0.6）mm。手术均顺利完成，无神经损伤、术后感染、腰椎不稳等手术并发症。术后CT显示椎管减压充分。随访6~18个月，平均（10.0±4.6）个月。疗效评定：优22例，良6例，可2例，差1例，优良率为90.3%（28/31）。

经皮脊柱内镜下可视化环锯单侧入路双侧减压技术治疗腰椎管狭窄症减压充分，创伤小、恢复快、费用低，而且术中安全性高，术后并发症发生率低，可最大限度减少对腰椎稳定结构的破坏，是一种治疗腰椎管狭窄症的理想微创手术。

To investigate the feasibility and efficacy of full-endoscopic trephination-based bilateral decompression via a unilateral approach in the treatment of lumbar spinal stenosis (LSS).

From September 2015 to September 2017, 31 cases of LSS were treated by full-endoscopic trephination-based bilateral decompression via a unilateral approach. The operative time, intraoperative blood loss, postoperative complications, and CT reexamination findings were recorded, the efficacy was evaluated according to the Nakai standard at the last follow-up, and the excellent/good result rate was calculated.

The operation time ranged from 65 to 125 min, with an average of (48±13) min. Intraoperative blood loss ranged from 25 to 180 ml, with an average of (37±9) ml. The incision length was about 7-8 mm, with an average of (7.0±0.6) mm. All the operations were successfully completed without complications such as nerve injury, postoperative infection, and lumbar instability. Postoperative CT showed adequate decompression of the spinal canal. The patients were followed for 6 to 18 months, with an average period of (10.0±4.6) months. With regard to curative effects, excellent, good, fair, and poor results were achieved in 22, 6, 2, and 1 case, respectively, with an excellent/good result rate of 90.3% (28/31).

Full-endoscopic trephination-based bilateral decompression via a unilateral approach in the treatment of LSS is associated with adequate decompression, small trauma, quick recovery, low cost, high safety, and low incidence of postoperative complications, and can minimize damage to the lumbar spinal structure, representing an ideal minimally invasive procedure for the treatment of LSS.