显微椎间盘镜治疗老年椎管狭窄症  

Microemdoscopic discefomy for the treatment of lumbar spinal stenosis in elderly patients

作　　者：张志士 羊国民 徐国平 郭德权 孔德宏 何文山 秦晖 

机构地区：[1]江苏大学附属第四人民医院骨科,江苏镇江212001

出　　处：《中国骨伤》2007年第3期161-162,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的：应用后路显微椎间盘镜（MED）治疗老年椎管狭窄症，探讨其临床价值。方法：21例65岁以上老年椎管狭窄症患者，男15例，女6例；平均年龄68．4岁。在局部麻醉或浅硬膜外麻醉下建立MED系统，凿去部分椎板及增生内聚的关节突，彻底解除硬脊膜及神经根周围压迫。结果：手术时间平均40～180min，出血量50～300ml。21例均获随访，时间8～40个月，平均15个月。按照Nakai标准进行疗效评定，本组优11例，良7例，可3例，优良率85．7％。结论：MED治疗老年椎管狭窄症创伤小、出血少、恢复快，能最大限度保持脊柱稳定性，是治疗老年椎管狭窄症的有效方法之一。Objective： To investigate the value of posterior approach microemdoscopic discefomy （MED） in the treatment of lumbar spinal stenosis in elderly patients. Methods： Twenty-one elderly patients who were older than 65 years （ 15 male ,6 female ,with an average age of 68. 4 years） with lumbar spinal stenosis were treated with the MED. The MED system was established under local anesthesia or epidural blockage. Part of lamina and cohesive articular processes were removed to fully decompress the dura mater and nerve roots. Results： The operation time ranged from 40 to 180 minutes with an intraoperative blood loss of 50 to 300 ml. All the patients were followed （ range, 8 to 40 months） ,with an average of 15 months. According to Nakai criteria, the outcome was excellent in 11 patients, good in 7 patients, fair in 3 patients and poor in none. The rate of good and excellent results was 85.7%. Conclusion： MED has advantages of minimal invasion, little blood loss and rapid recovery, and it can keep stability of spine to greater possibility which is an effective way in the treatment of lumbar spinal stenosis in elderly patients.

关 键 词：椎管狭窄 显微外科手术 老年人 减压 

分 类 号：R681.53[医药卫生—骨科学]