老年腰椎退行性疾病患者不同手术疗效的比较  

Different operation methods for treatment of elderly patients with lumbar degeneration diseases:a comparison of outcomes

作　　者：吴叶[1] 曹峥[1] 商卫林[1] 卜国云[1] 任东风[1] 张宇鹏[1] 吴闻文[1] 侯树勋[1] 

机构地区：[1]解放军总医院第一附属医院全军骨科研究所,北京100048

出　　处：《脊柱外科杂志》2012年第5期296-298,共3页Journal of Spinal Surgery

摘　　要：目的评估老年腰腿痛患者单纯开窗减压与开窗减压椎间植骨结合内固定2种手术的治疗效果。方法回顾性分析70例老年腰腿痛患者的病历资料,所有患者均存在明显腰椎椎管狭窄。按照手术方式分为A、B 2组。A组28例,单纯开窗减压手术,患者一般合并普通疾病2或3个,手术节段3.26±0.42;B组42例,采用开窗减压椎间植骨结合椎弓根螺钉系统内固定手术,患者一般合并普通疾病2或3个,手术节段2.44±0.63。分析患者住院期间以及出院1年以后症状改善情况,结合问卷调查患者对治疗的满意程度,比较老年腰腿痛患者不同治疗方法的治疗效果。结果 2组患者术后腰腿痛均得到明显缓解,生活质量显著提高。2组患者的满意率分别为82.2%和71.5%。但是在手术时间、手术中出血量、术后引流量等方面,2组间均存在显著差异,差异具有统计学意义(P<0.05)。结论对于老年腰腿痛患者,腰椎单纯后路开窗减压、后路开窗减压内固定手术后腰腿痛均得到明显缓解、生活质量显著提高,单纯开窗减压手术可以显著缩短手术时间、减少术中出血量、减少术后引流量,手术安全性更高。Objective To compare the treatment effects of lumbar posterior window decompression alone or in combination with interfixation surgery in elderly patients with lumbar degeneration diseases.Methods A total of 70 old patients were retrospectively analyzed with different lumbar degeneration diseases who underwent different lumbar posterior surgery form Janunay 2007 to December 2009.Group A included 28 patients with lumbar stenosis who were treated by lumbar posterior window decompression.Group B included 42 patients with lumbar stenosis or spondylolisthesis who were treated by lumbar posterior window decompression combined with interfixation surgery.The improvements in the patients during the hospital and 1 year after discharge were used,together with the satisfactory rate of the patients（by questionnaire survey） to compare the efficiencies of the 2 methods.Results Patients in both groups experienced relief of pain and improvement of life quality.The satisfaction rates in the 2 groups were 82.2% and 71.5%.The operation time blood loss,and drainage after operation were significantly different between the 2 groups（P0.05）.Conclusion The 2 methods can both relieve the back pain in eldly patients with lumbar degeneration diseases and improve their quality of life.Simple posterior window decompression can greatly shorten operation time and reduce blood loss and postoperative drainage.

关 键 词：老年人 腰椎 椎管狭窄 减压术 外科 骨移植 内固定器 

分 类 号：R681.533.2[医药卫生—骨科学]