多节段开窗减压桥式成形术治疗退行性腰椎管狭窄症的疗效评价  

Multi-segmental Spinal Canal Decompression with Arch Bridge-shaped Osteotomy for Degenerative Lumbar Spinal Stenosis

作　　者：汪曾荣[1] 汪细安 彭建强[1] 陈瑞云[1] 黄爱军[1] 黄醒中[1] 邹庆宝[1] 郑汉雄[1] 

机构地区：[1]广东医学院附属深圳福田人民医院深圳市第四人民医院骨科,深圳518033 [2]深圳市福田区中医院,深圳518000

出　　处：《中国现代手术学杂志》2009年第5期360-362,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨多节段开窗减压桥式成形术治疗退行性腰椎管狭窄症的疗效。方法采用经椎板间隙开窗减压桥式成形术扩大中央椎管和神经根管,并摘除突出之椎间盘治疗退行性腰椎管狭窄症共42例,其中单节段减压5例,双节段减压21例,3节段减压13例,4节段减压3例。结果42例随访6-79个月,根据JOA标准评定疗效：优12例,良24例,中4例,差2例（为发病前已有脊柱＂S＂形侧弯者）;优良率85.7%。发生硬膜撕裂1例,脑脊液漏2例。除1例椎间盘突出复发再行手术治疗外,无腰椎滑脱发生。结论多节段开窗减压桥式成形术治疗退行性腰椎管狭窄症不仅对各病变节段减压彻底,而且有效保护了腰椎生物力学结构,术式合理,疗效满意。Objective To study the curative effect of multi-segmental spinal canal decompression with arch bridge-shaped osteotomy for degenerative lumbar spinal stenosis. Methods 42 patients suffered from degenerative lumbar spinal stenosis were treated by multi-segmental spinal canal decompression with arch bridge-shaped osteotomy. Among them, single segment decompression was performed in 5 cases, double segments in 21 cases, three segments in 13 cases, and four segments in 3 cases. Results All cases were followed-up for 6 to 79 months. According to JOA standard, the result revealed excellence in 12 cases, good in 24 cases, fair in 4 cases, and false in 2 cases with S-shaped spinal scoliosis preoperatively. The fineness rate was 85.7%. Dura laceration was found in 1 case and cerebrospinal leakage in 2 cases. The reoperation was performed in 1 case because of disc herniation recurrence. No lumbar spondylolisthesis occurred. Conclusion Multi-segmental spinal decompression with arch bridge-shaped osteotomy is a reasonable and effective procedure for degenerative lumbar spinal stenosis, it can afford not only decompress thoroughly but also reserves spinal biomechanics structure effectively.

关 键 词：腰椎 椎管狭窄 

分 类 号：R687.3[医药卫生—骨科学]