老年腰椎间盘突出症合并腰椎管狭窄症特点与治疗  

Characteristics and treatment of the senile lumbar disc herniation with spinal stenosis

作　　者：刘钦毅[1] 杨有庚[1] 郑长军[1] 白云深[1] 程杰平[1] 任宪盛[1] 

机构地区：[1]吉林大学白求恩医学部第二临床学院,吉林长春130041

出　　处：《中国骨伤》2005年第6期324-325,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:研究老年腰椎间盘突出症合并椎管狭窄症的临床表现、影像学表现、病理解剖特点及外科治疗方法。方法:回顾分析了147例(男89例,女58例)老年腰椎间盘突出症合并椎管狭窄症患者临床表现、CT、MRI特点及病理解剖特点,病程2周～15年。病变阶段:L4,553例,L5S142例,L3,45例,L2,33例,L4,5和L5S1并存44例。全部病例采用椎板减压髓核摘除术,并对治疗方法进行分析。结果:本组92例获得随访,随访时间3个月～3年,平均8个月。术后功能按我们自己制定方法进行评定,优63例,良17例,可10例,差2例,优良率为87%。结论:老年腰椎间盘突出症合并椎管狭窄症具有临床表现不典型、症状与体征不完全一致的特点,并有其特殊的影像学表现。在治疗上应行全椎板减压,髓核摘除,扩大椎管及侧隐窝,使患者获得良好的功能恢复。Objective: To investigate the characteristics of pathological anatomy,clinical and radiographic presentation and surgical treatment of senile lumbar disc herniation with spinal stenosis.Methods:One hundred and forty-seven patients of senile lumbar disc herniation with spinal stenosis were treated and reviewed retrospectively,and all patients were treated with total lamiectomy and excision of nucleus pulposus.Results:Ninty-two patients were followed up for 3 months to 3 years with an average of 8 months.According to the standardization determined by us,63 cases were excellent,17 cases good,10 cases fair,2 cases poor.The excellent and good rate was 87%.Conclusion:There are many characteristics in patients of senile lumbar disc herniation with spinal stenosis,such as atypical symptoms and specific radiograghic presentation.During operations,resecting of nucleus pulposus,total laminectomy and amplifying of medial canal and lateral recess should be performed to release nerve root completely.

关 键 词：老年 腰椎间盘突出症 腰椎管狭窄症 髓核摘除 全椎板减压 

分 类 号：R681.53[医药卫生—骨科学]