椎板减压术治疗退变性腰椎管狭窄症60例中远期疗效观察  

Long-term clinical efficacy of laminectomy in the treatment of degenerative lumbar spinal stenosis: a report of 60 cases

作　　者：李华[1] 曹贞国[1] 魏东[1] 

机构地区：[1]徐州医学院第二附属医院骨科,江苏徐州221006

出　　处：《海南医学》2011年第22期81-82,共2页Hainan Medical Journal

摘　　要：目的分析椎板减压术治疗退变性腰椎管狭窄症的中远期临床疗效。方法除腰椎失稳、滑脱、侧弯及广泛减压小关节破坏的患者需要行内固定及植骨融合术外,一般依据患者椎管狭窄的情况,分别单纯采用开窗减压、半椎板减压、全椎板减压的手术方法治疗腰椎管狭窄症。结果本组共60例,其中男39例,女21例,年龄53~72岁,平均61岁;随访时间6~82个月,平均46.6个月。术按改良腰椎功能障碍指数（MODI）,优43例,良12例,可2例,差3例,优良率为91.7%,后疼痛完全缓解率为86.5%（32/37）,跛行改善率为84.6%（11/13）,28例感觉障碍者,完全恢复17例（60.7%）,部分恢复8例（28.6%）,无明显恢复3例（10.7%）。结论对于退变性腰椎管狭窄症的患者,依据狭窄的情况单纯采用开窗减压、半椎板减压、全椎板减压的手术方法是一种有效的治疗方法。Objective To investigate the long-term clinical efficacy of laminectomy in the treatment of degenerative lumbar spinal stenosis. Methods Sixty patients with degenerative lumbar spinal stenosis were treated with the fenestration, semi laminectomy or decompression laminectomy according to the status of spinal stenosis. Those with lumbar instability, spondylolisthesis, scoliosis, and decompression with extensive destruction of small joints require internal fixation and bone grafting. All the patients were followed up for 6 to 82 months, with an average of 46.6 months. Results According to MODI, the results were excellent in 43 cases, good in 12 cases, fair in 2 cases and poor in 3 cases. The excellent and good rate was 91.5%. The rate of complete remission of pain was 86.5% （32/37）, the rate of improved claudication was 84.5% （11/13）. For the 28 patients with sensory disabilities, 17 cases were found with complete recovery （60.7%）, 8 cases with complete recovery in （28.6%）, and 1 case with no significant recovery （10.7%）. Conclusion According to the status of spinal stenosis, to use the fenestration, semi laminectomy or decompression laminectomy for treating lumbar spinal stenosis is effective.

关 键 词：椎管狭窄 椎板减压 疗效 

分 类 号：R681.5[医药卫生—骨科学]