老年人破裂型腰椎间盘突出症的手术疗效分析  

Clinical Efficiency of Surgical Treatment for Ruptured Lumbar Disc Herniation in Elderly Patients

作　　者：曾锦源[1] 叶君健[1] 陈雷[1] 陈春永[1] 谢昀[1] 谢其扬[1] 林章雄[1] 

机构地区：[1]福建医科大学附属第一医院骨科,福建福州350000

出　　处：《实用骨科杂志》2012年第11期961-963,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨和评价老年人破裂型腰椎间盘突出症的临床诊断和手术治疗效果。方法回顾性研究2003年6月至2011年6月我科收治的65例有完整随访资料的老年人破裂型腰椎间盘突出症手术病例,其中男39例,女26例;年龄60～83岁,平均(66.1±6.0)岁,分析一般资料、临床特点、手术治疗方案的疗效。根据术中是否行椎间植骨融合及椎弓根螺钉系统内固定,将术式分类为单纯髓核摘除术组(共45例)和融合内固定术组(共20例)。结果按Macnab疗效评定标准,本组优34例,良23例,可8例,差0例,优良率87.7%。其中单纯髓核摘除术组:优22例,良16例,可7例,差0例,优良率84.4%;融合内固定术组:优12例,良7例,可1例,差0例,优良率95.0%。结论诊断明确的老年人破裂型腰椎间盘突出症建议尽早手术治疗,术中应在充分减压的基础上,尽量维持脊柱的稳定性,必要时行椎间植骨融合及椎弓根螺钉系统内固定。Abstract：Objective To analyze the Clinical efficiency of surgical treatment for ruptured lumbar disc herniation in elderly patients. Methods 65 cases of elderly ruptured lumbar disc underwent discectomy from June 2003 to June 2011 was retrospectively analyzed. The patients were devided into discectomy group and diseectomy plus fusion group. Results According to the Macnab outcome criteria,the outcomes were excellent in 34 cases,good in 23,fair in 8,and the excellent and good rate was 87.7%. Discectomy group：excellent in 22 cases,good in 16,fair in 7,excellent and good rate was 84.4% ;Fixation fusion group ：excellent in 12 cases ,good in 7 ,fair in 1 ,excellent and good rate was 95%. Conclusion It is suggested early operation for elderly ruptured lumbar disc herniation. After complete decom- pression ,keeping the spinal stability is important. Fixation and fusion should be done ,if necessary.

关 键 词：老年人 腰椎间盘突出症 破裂型 手术 疗效 

分 类 号：R681.53[医药卫生—骨科学]