老年人退行性腰椎管狭窄症手术治疗探讨  

Operative result of senile people with degenerative lumbar spinal canal stenosis

作　　者：胡文军[1] 刘社庭[1] 刘晓岚[1] 兰图[1] 童杰[1] 

机构地区：[1]湖南郴州市第一人民医院脊柱外科,湖南郴州423000

出　　处：《中国现代医学杂志》2009年第10期1538-1540,1543,共4页China Journal of Modern Medicine

摘　　要：目的探讨老年人退行性腰椎管狭窄症手术治疗的方法及围手术期处理。方法1998年6月～2006年10月收治的60岁以上且获得1.5～5年随访的退行性腰椎管狭窄症患者85例,38例并存一种内科疾病,42例并存2种以上的内科疾病。术前控制并存的内科疾病。根据病情分别采用单纯椎管减压37例(一组),椎管减压并小关节,横突间和(或)椎间植骨融合48例,并均采用椎弓根螺钉钉棒系统固定(二组)。对于手术效果进行回顾性分析。结果无围手术期死亡病例,术后出现并发症18例,经对症及内科联合处理后好转,单纯减压组优良率78.4%;减压植骨融合内固定组优良率84.4%;手术并发症发生率分别为13.51%和20.83%。结论老年退行性腰椎管狭窄症患者,只要加强围手术期的治疗,选择适当的手术方法,手术治疗可以获得较满意的临床疗效。[Objectives] To investigate the clinical effect and peri-operation treatment of senile people with degenerative Lumbar spinal canal stenosis treated with surgical decompression combined internal fixation. [Method] From June 1998 to December 2006, a retrospective study of 85 eases with ＇degenerative lumbar canal stenosis acquired a follow-up of 1.5-5 years, of the 85 patients aged 60 and over, there were 38 eases suffered one type of morbus internus concomitantly, 42 eases suffered at least 2 types of morbus internus concomitant diseases, after controlling eoneomintant internal disease preoperation, spinal canal decompression were performed in all 85 eases. Furthermore 48 cases were treated with transpedical screw system for internal fixation and interbody fusion diviee for intervertebral fusion, posterolaterd fusion arthrodesis or posterol-ateral bone graft was used. [Results] No death eases oeurred during peri-operation. 18 cases were noted to have complications after operation which improved with symptomatic treatment, the satisfactory rate of the two groups was 78.4% and 84.4% and the incidence of complications with 13.51% and 20.83%. [Conclusion] The treatment of senile people with degenerative lumbar spinal canal stenosis and acquired satisfactory therapeutic effect, peri-operation treatment and strict select the perfect surgery are necessary.

关 键 词：腰椎管狭窄 老年 手术 

分 类 号：R681.533[医药卫生—骨科学]