51例高龄腰椎间盘突出症的手术治疗探讨  

Retrospect of Operative Treatment to 51 Senile Cases with Lumbar Disc Herniation

作　　者：冯灿林[1] 涂平生[1] 

机构地区：[1]广东省广州市番禺区中医院骨科,广东番禺511400

出　　处：《临床医学工程》2009年第3期33-34,共2页Clinical Medicine & Engineering

摘　　要：目的探讨高龄腰椎间盘突出症的手术治疗方法和疗效。方法对51例患者术前临床症状及影像学进行分析,行后路减压,椎间盘髓核摘除,神经根管、侧隐窝扩大、植骨、椎弓根钉内固定术。结果本组病人手术前,出院时和随访的结果均参考JOA治疗评价标准,对其功能及疗效进行评价,结果为:优39例(76.46%),良8例(15.64%),可3例(5.88%),差1例(1.96%),总优良率为(92.10%)。结论高龄腰椎间盘突出症的手术治疗过程中,必须始终注意处理好减压,植骨融合和内固定三方面的问题,忽略神经根管、侧隐窝的处理将导致手术效果不佳甚至失败。Objective： To evaluate operative treatment to lumbar disc herniation in senile patients. Method： 51 lumbar disc herniation cases with pre-operative clinical symptoms and radiography materials were analyzed. The operation was done with the manner of posterior decompres- sion, discectomy, enlargement of nerve root canal and lateral recess, bone graft and pedicle screw fLxation. Results： JOA criteria was used in point ofpre-operation, discharge and follow-up. The outcome was excellent in 39 cases（76.46%）, good in 8 cases（l 5.64%）, general in 3 cases （5.88%）, poor in one case（1.96%）. Excellent and good rate were 92.10%. Conclusion： In the surgical treatment of lumbar disc hemiation in senile patients, decompression, bone graft and internal fixation are three aspects of most concern. Failure may be due to ignorance of decompres- sion of nerve root canal and lateral recess.

关 键 词：高龄 后路减压 椎间 椎旁植骨 侧隐窝狭窄 

分 类 号：R681.53[医药卫生—骨科学] R687.32[医药卫生—外科学]