腰椎椎体后缘离断症的临床治疗  

Clinical treatment of posterior bony edges separation of lumbar vertebrae

作　　者：孙天威[1] 张杭[2] 卢守亮[2] 李辉南[1] 于斌[1] 张学利[1] 

机构地区：[1]天津市人民医院脊柱外科,天津300121 [2]天津医科大学研究生院,天津300070

出　　处：《临床骨科杂志》2012年第1期4-6,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨手术治疗腰椎椎体后缘离断症的疗效及适应证。方法对31例腰椎椎体后缘离断症患者的临床资料进行回顾性分析,应用JOA评分及改善率评价手术治疗效果。结果随访3～4年,JOA评分术前为14.67分±2.08分,术后3个月为24.84分±4.43分,差异有统计学意义(P<0.01);末次随访时为27.58分±2.12分,与术后3个月时比较差异无统计学意义(P>0.05)。末次随访时手术满意程度:优27例,良2例,可2例,优良率为93.5%。随访期内间盘组织全切组与未全切组临床效果比较差异无统计学意义(P>0.05)。结论手术治疗腰椎椎体后缘离断症疗效满意。马尾综合征及足下垂是绝对手术适应证;术中需根据具体情况选择性切除间盘组织及关节突并尽可能保证脊柱稳定性。Abstract Objective To study the surgical treatment indications of posteri＆ bony edges separation of lumbar verte- brae and its clinical effect. Methods 3i cases of posterior bony edges separation of lumbar vertebrae were treated and its clinical data were retrospectively analyzed： Each patients＇ preoerative and post6perative status was evaluated based on the Japanese Orthopedic Association （JOA） functigrml scalesitResults Follow-up period ranged from 3 to 4 years,The preoperative JOA score was 14. 67 ±2.08. When followed by 3nths, the score changed into 24. 84 ＋ 4.43, there was statistical significance between them（P 〈 0. 01 ） . At the end of follow-up, the JOA score was 27.58 ±2. 12 without significant difference compared with cases of 3 months postoperatively. Satisfaction with the end of follow-up surgery： excellent in 27 cases, good in 2 cases, fair in 2 cases, and excellent and good results were 93.5%. Total disc resection group and subtotal group were no difference between the clinical results （ P 〉 0. 05 ）.

关 键 词：椎体后缘离断症 腰椎间盘突出症 手术适应证 

分 类 号：R683.2[医药卫生—骨科学] R681.5[医药卫生—外科学]