32例退变性腰椎管狭窄症的手术治疗  

Surgical treatment for 32 patients with lumbar spinal stenosis following degeneration

作　　者：杨华[1] 邢维平[1] 尚显文[1] 宁旭[1] 张皓[1] 

机构地区：[1]贵阳医学院附属医院脊柱外科,贵州贵阳550001

出　　处：《临床骨科杂志》2010年第5期536-537,共2页Journal of Clinical Orthopaedics

摘　　要：目的探讨退变性腰椎管狭窄症(LSS)手术方式及疗效。方法根据32例LSS患者的症状、体征及影像学表现等临床特点,选择全椎板切除、侧隐窝及椎间孔减压、椎弓根螺钉固定、横突间及小关节后外侧植骨术,术后随访,评价手术效果。结果 32例均获随访,时间6个月～5年。采用JOA评分标准评价术后疗效,优21例,良7例,中4例,优良率为87.5%。结论患者全椎板切除、侧隐窝及椎间孔减压、经椎弓根螺钉固定、横突间及小关节后外侧植骨术是治疗LSS安全、有效的手术方式。Objective To analyze and summarize the clinical characteristics of lumbar spinal stenosis following degeneration for safe and effective surgical treatment.Methods In accordance with the clinical characteristics,including the symptoms,signs and imaging findings of the 32 patients,wide laminectomy,lateral recess and intervertebral foramen decompression,trans-pedicel screw fixation,intertransverse and the facet joints lateral bone grafting were applied accordingly.Follow-ups were made to evaluate the effect of surgery.Results All cases were followed up for 6 months to 5 years.The results were evaluated in accordance with the standard of JOA,which were excellent in 21 cases,good in 7,fair in 4,and the excellent and good rate was 87.5%.Conclusions The surgical method of wide laminectomy,lateral recess and intervertebral foramen decompression,trans-pedicel screw fixation,intertransverse and facet joints lateral bone grafting are safe and effective for lumbar spinal stenosis.

关 键 词：腰椎管狭窄症 全椎板切除 螺钉固定 植骨 

分 类 号：R681.533.2[医药卫生—骨科学] R687.3[医药卫生—外科学]