退变性腰椎管狭窄症的手术治疗  

Surgical Treatment of Degenerative Lumbar Spinal Canal Stenosis

作　　者：王智[1] 周雪明[1] 朱文雄[1] 

机构地区：[1]东莞市人民医院普济分院骨科,广州东莞523000

出　　处：《河南职工医学院学报》2008年第4期327-330,共4页Journal of Henan Medical College For Staff and Workers

摘　　要：目的探讨全椎板切除减压，椎弓根内固定，横突间植骨融合治疗退变性腰椎管狭窄症的临床疗效和术中要点及椎弓根内固定的作用和意义。方法总结2005年7月～2007年6月采用广泛椎板减压椎弓根内固定及横突间植骨融合治疗的32例退变性腰椎管狭窄症病例的临床资料。结果32例随访6～24个月，平均10．5个月，术后跛行改善者32例（100％），下肢肌力障碍恢复24例（75％），肌萎缩11例均有所改善；28例感觉障碍者，完全恢复7例（25％），部分恢复16例（57．1％），无明显恢复5例（17．9％）。结论全椎板切除减压，椎弓根内固定，横突间植骨融合治疗腰椎管狭窄症的临床疗效满意。术中椎弓根内固定可起到使滑脱椎体复位，有利于相邻椎体间稳定及椎间融合的作用。Objective To evaluate the surgical outcome of extensive vertebral lamina decompression,trans-vertebral pedicle internal fixation,inter-vertebral fusion and inter-transverse process bone graft and study the key point of degenerative lumber spinal canal stenosis surgery and the principle and the significance of traps-pedicle internal fixation in lumbar spinal canal stenosis.Methods 32 lumber spinal canal stenosis cases were treated with extensive vertebral lamina decompression,trans-vertebral pedicle internal fixation,inter-vertebral fusion and inter-transverse process bone graft from July 2005 to June 2007.Results 32 cases were followed-up for 6-24 months(average of 10.5 months),with limping ameliorated in 32 cases(100%) and lower extremities myodynamia recovered in 24 cases(75%).all of the 11 myoatrophic patients gained some recovery.Among the 28 sensory disability cases,7 cases(25%)fully recovered,16 cases(57.1%)partially recovered,5cases(17.9%)barely showed any recovery.Conclusion Extensive vertebral lamina decompression,trans-vertebral pedicle internal fixation,inter-vertebral fusion and inter-transverse process bone graft for degenerative lumber spinal canal stenosis produce satisfactory surgical results.Frans-pedicle internal fixation can make reduction,vertebra stabilization and fusion for the patients with lumber structural and dynamic slippage.

关 键 词：全椎板切除减压 椎弓根内固定 横突间植骨融合 退变性腰椎管狭窄症 

分 类 号：R681.5[医药卫生—骨科学]