腰椎管狭窄症的不同术式选择及其疗效比较  

Options of Surgical Methods and Comparison of Effects for Treatment of Lumbar Spinal Canal Stenosis

作　　者：林小斌[1] 林其仁[1] 

机构地区：[1]福建医科大学附属第二医院骨科,福建省泉州市362000

出　　处：《中国骨与关节损伤杂志》2006年第12期951-953,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探 讨不同类型腰椎管狭窄症的手术指征和术式选择，并对其疗效进行比较。方法 回顾性分析1998～2004年入院治疗的腰椎管狭窄症患者187例，其中156例获得随访。根据病情分别采用单纯椎板减压术（全椎板或半椎板）89例，椎板减压＋横突间植骨融合术33例，全椎板切除减压＋横突间植骨融合＋椎弓根钉棒系统内固定术34例。结果 156例术后随访6个月～7年，平均4年1个月。三种手术方法优良率分别为89．89％、87．88％、88．24％。结论 只要掌握好手术指征和手术技巧，选择适当的手术方式，各种类型的腰椎管狭窄症均可获得满意疗效。Objective To evaluate the different surgical methods for the treatment of lumbar spinal stenosis, the surgical indications of lumbar spinal stenosis and comparison of the respective effect. Methods A total of 187 patients with 156 followed up ot lumbar spinal canal stenosis from 1998 to 2004 were analyzed retrospectively. The average age was 52.5 years and the average history was 4 years and 5 months. One hundred and fifty- six patients were divided into three groups. Group Ⅰ comprising 89 patients was treated with the simple surgical decompression （the laminectomy or the hemilaminectomy）. Group Ⅱ comprising 33 patients was treated with the laminectomy and the intervertebral fusion. Group Ⅲ comprising 34 patients was treated with the laminectomy, the intervertebral fusion and pedical screw system internal fixation. Results A total of 156 patients were followed up for 6 months to 7 years and the average followed- up was 4 years and 1 month. The satisfactory rate of the three groups was 89.89 % , 87.88 % , and 88.24 % respectively. Conclusion The results of the different surgical methods for the treatment of different types of lumbar spinal stenosis are satisfactory. The strict surgical indications, the skilled surgical technique, and the proper surgical methods are the key to the good result with less complications.

关 键 词：椎管狭窄症 腰椎 椎板减压术 植骨融合 内固定 

分 类 号：R681.5[医药卫生—骨科学]