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Item type:Publication, Дегенерацийн шалтгаант бүсэлхийн багана нурууны сувгийн нарийсалтай үйлчлүүлэгчдэд зарим эрсдэлт хүчин зүйлсийг судалсан дүн(2024-12-21); ; ; Үндэслэл: Багана нурууны сувгийн нарийсал нь мэдрэлийн мэс засал судлалын нэн тулгамдсан асуудлуудын нэг бөгөөд хөгжил багатай орнуудад багана нурууны сувгийн нарийсал илүү их тохиолдож байна. Өнөө үед дундаж наслалт тасралтгүй нэмэгдэж байгаатай холбоотойгоор энэ эмгэгийн хоёрдогч шалтгаантай багана нурууны сувгийн нарийсал ихэнх хувийг эзэлж байна. Дегенерацийн шалтгаант бүсэлхийн багана нурууны мэс засал эмчилгээний үр дүнг үл харгалзан дахин мэс засал хийх тохиолдол байсаар байгаа нь энэхүү судалгааны үндэслэл боллоо. Зорилго: Бүсэлхий багана нурууны сувгийн нарийслын улмаас дурангийн мэс заслын хийлгэсэн хүмүүсийн дундах мэс заслын үр дүнд нөлөөлөх эрсдэлт хүчин зүйлсийг судлах. Арга, аргачлал: Судалгааг асуумж судалгааны аргаар эмнэлэгт суурилсан агшингийн загвараар Грандмед эмнэлэгт 2019-2023 оны хооронд бүсэлхийн багана нурууны сувгийн нарийсал оношоор багана нурууны суваг чөлөөлөх дурангийн мэс засал (PSLD-Percutaneous Stenoscopic Lumbar Decompression) хийлгэж онош нь батлагдсан, судалгаанд оролцохыг зөвшөөрсөн 97 үйлчлүүлэгчийг хамруулав. Үр дүн: Судалгаанд хамрагдагсдын 46 (47.42%) нь эрэгтэй, дундаж нас 53±21.7 жил, 51 (52.58%) нь эмэгтэчүүд байсан ба дундаж нас 58±16.6 жил байв. Судалгаанд хамрагдагсдын 73.2% (n=71) нь илүүдэл жинтэй, 21.5% нь амьдралын хэв маягтай холбоотой буюу суугаа ажил хийдэг, дасгал хөдөлгөөн бага хийдэг (17.2%), 15.8% хүнд юм байнга өргөдөг зэрэг эрсдэлт хүчин зүйлст өртдөг үйлчлүүлэгч байгаа нь тогдорхойлогдлоо. Түүнчлэн судалгаанд хамрагдагсдын 80.4% (n=78) нь 2 ба түүнээс дээш хүчин зүйлст хавсарч өртсөн байв. Мөн 57.73% нь 1-5 жилийн дараа мэс засал эмчилгээ хийлгэсэн байлаа. Дүгнэлт: Дегенерацийн шалтгаант бүсэлхийн багана нурууны сувгийн нарийслийн улмаас мэс засал эмчилгээ хийлгэсэн хүмүүсийн дунд биеийн жингийн илүүдэл, хөдөлгөөний идэвхигүй амьдралын хэв маяг хамгийн их тохиолдож байна. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Predictors of Long-Term Outcomes after Endoscopic Spinal Decompression in Patients with Lumbar Spinal StenosisBackground. ESD is a minimally invasive procedure to alleviate disability in LSS patients. However, long-term predictors of suboptimal surgical outcomes remain unclear. We aimed to investigate the predictors of long-term outcomes in patients with lumbar spinal stenosis (LSS) treated with endoscopic spinal decompression (ESD) surgery. Material and methods. Patients with LSS unresponsive to conservative treatment underwent ESD surgery. Disability was assessed using the Oswestry Low Back Pain (LBP) Disability Questionnaire, reported as the Oswestry Disability Index (ODI), at pre-surgery, post-surgery, and 1-year follow-up. Patients were grouped based on the presence or absence of spinal instability. Results. 93 patients (mean age 55±14, 55% female) with LSS who underwent ESD due to persistent LBP were included. Pre-surgical ODI significantly decreased post-surgery in both groups (spinal instability: 25 [IQR 19-33] vs. 3 [IQR 1-7], p<0.001; no spinal instability: 30 [IQR 24-35] vs. 2 [IQR 1-4], p<0.001). However, the spinal instability group had higher post-surgical ODI (3 [IQR 1-7] vs. 2 [IQR 1-4], p=0.018) and 1-year ODI (14 [IQR 2-24] vs. 3 [IQR 1-7], p=0.013) compared to the no spinal instability group, where ODI remained stable (2 [IQR 1-4] vs. 2 [IQR 1-4], p=0.785). Multivariable linear regression identified multilevel degenerative disc disease (β=3.357, 95% CI 0.610-6.105, p=0.017) and spinal instability (β=7.368, 95% CI 3.370-11.365, p<0.001) as independent predictors of 1-year ODI. Conclusions. 1. ESD surgery significantly improves disability, as measured by ODI, in patients with LSS, regardless of spinal instability. 2. Multilevel degenerative disc disease and spinal instability are long-term predictors of outcomes following ESD surgery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Role of Endoscopic Spinal Decompression Surgery in Amelioration of Disability in Patients with Lumbar Spinal StenosisBACKGROUND: Degenerative lumbar spinal stenosis (LSS) is a common cause of chronic low back pain (LBP) and is often associated with various degrees of disability. Endoscopic spinal decompression (ESD) is a minimally invasive surgical approach for treating degenerative LSS. However, the impact of ESD on the rehabilitation of disability in patients with LSS remains unclear. MATERIAL AND METHODS: Patients with LSS who underwent ESD surgery were selected prospectively. The disability status was evaluated as the Oswestry Disability Index (ODI) using a standard Oswestry LBP disability questionnaire pre- and post-surgery and at 1-year follow-up. Based on pre-surgical ODI, patients were classified into mild and moderate-to-severe disability groups. RESULTS: A total of 93 patients with LSS who underwent ESD surgery (mean age5514 and female 55%) were included. Fourteen patients were classified into a mild disability group, while 79 patients were placed in a moderate-to-severe disability group. Pre-surgical ODI scores were significantly lower in the mild disability group compared to the moderate-to-severe disability group (17, IQR 13-19 vs. 31, IQR 25-35, p<0.001). After ESD surgery, ODI was significantly reduced in both mild (17, IQR 13-19 vs. 3, IQR 0-4, p=0.016) and moderate-to-severe disability groups (3, IQR 0-4 vs. 2, IQR 1-5, p<0.001). Post-surgical ODI scores were similar between the study groups (3, IQR 0-4 vs. 2, IQR 1-5, p=0.656). These improvements in ODI were maintained at the 1-year follow-up in the mild (3, IQR 0-4 vs. 2, IQR 0-8, p=0.766) and moderate-to-severe disability groups (2, IQR 1-5 vs. 3, IQR 1-5, p=0.078). The 1-year ODI scores remained comparable between the mild and moderate-to-severe disability groups (2, IQR 0-8 vs. 3, IQR 1-5, p=0.581) Conclusions. 1. Endoscopic spinal decompression surgery is associated with significant improvements in disability, as measured by the Oswestry Disability Index, in both mild and moderate-to-severe disability patients. 2. Post-surgical amelioration of disability is sustained for at least one year following the surgery. 3. These findings support the use of early intervention with minimally invasive endoscopic spinal decompression in mild disability patients with degenerative lumbar spinal stenosis.