复杂性腰椎管狭窄症术式选择  

Choosing of Surgical Methods for Treating Complex Lumbar Spinal Stenosis

作　　者：林小斌[1] 林其仁[1] 姚学东[1] 

机构地区：[1]福建医科大学附属第二医院骨科,福建泉州362000

出　　处：《中国中医骨伤科杂志》2012年第10期23-25,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨适合于治疗复杂性腰椎管狭窄症的手术方法并观察其临床疗效。方法:回顾性分析2006年1月～2010年1月入院治疗并获得随访的复杂性腰椎管狭窄症患者56例。平均年龄52.9岁,平均病程4年5个月。分别采用椎板减压术治疗(减压组)12例,椎板减压后外侧植骨融合术治疗(融合组)15例,全椎板切除减压+椎间植骨融合+椎弓根内固定术治疗(固定组)29例,术后按日本矫形外科协会(JOA)下腰痛评分标准进行疗效评定。结果:术后1年三种手术方法优良率分别为75.00%、80.00%、96.55%;术后4年三种手术方法优良率分别为50.00%、53.33%、93.10%.结论:椎板减压椎间融合椎弓根内固定术比较适合于治疗复杂性腰椎管狭窄症,其术后中期疗效优于单纯椎板减压术或椎板减压后外侧融合术。Objective： To detect suitable surgical method for treating complex lumbar spinal stenosis,and to observe its curative effect.Methods：All 56 cases of complex lumbar spinal stenosis of our hospital from 2006 to 2010 were analyzed retrospectively.The average age was 52.9 years,and the mean pathogenesis was 4.5 years.They were divided into three groups.Group I consisted of 12 cases,which were treated with laminectomy.Groupe II consisted of 15 cases,which were treated with laminectomy and posterolateral fusion.Group III consisted of 29 cases,which were treated with laminectomy,intervertebral fusion,and pedicle screws system internal fixation.The surgical outcomes were evaluated with JOA score from one to four years postoperatively.Results：The fineness rate of the three groups was 75.00%,80.00%,and 96.55% respectively one year after surgery,and they were 50.00%,53.33%,and 93.10% respectively four year after surgery.Conclusion：Laminectomy,intervertebral fusion,combined with pedicle screws system internal fixation is proper to treat complex lumbar spinal stenosis.Its medium-term surgical outcomes are better than single laminectomy and posterolateral fusion.

关 键 词：腰椎 椎管狭窄症 复杂性 外科手术 

分 类 号：R687.3[医药卫生—骨科学]