下关节突切除椎管有限减压内固定治疗退行性腰椎管狭窄症  

Spinal Limited Decompression and Internal Fixation by Resecting Inferior Articular Process for Treating Degenerative Lumbar Spinal Stenosis

作　　者：李宁[1] 李霞[1] 邓桂[1] 梁届东[1] 

机构地区：[1]宜昌市第一人民医院骨科,湖北宜昌443000

出　　处：《医学综述》2012年第22期3899-3901,共3页Medical Recapitulate

摘　　要：目的观察单(双)侧下关节突切除椎管减压内固定治疗重度退行性腰椎管狭窄症的疗效。方法运用单(双)侧下关节突切除椎管减压,短节段椎弓根螺钉内固定,后外侧植骨融合的方法,治疗重度退行性腰椎管狭窄症30例。术后1年随访,比较JOA评分变化。结果术前平均(4.203±0.021)分,术后1年平均(12.701±0.017)分,两者比较差异有统计学意义(t=2.438,P=0.035);优19例、良7例、中4例,优良率为86.7%。结论单(双)侧下关节突切除椎管减压内固定术,最大限度的保留了脊柱的后柱结构(维持了脊柱的稳定性),提高了脊髓的骨性覆盖面积,减少了硬膜外的瘢痕粘连,消除了由于小关节突增生导致的腰痛,是治疗重度腰椎管狭窄症的一种较好的方法。Objective To observe the clinical effect of decompression of spinal canal with resection inferior articular process for treating degenerative lumbar spinal stenosis.Methods 30 cases of degenerative lumbar spinal stenosis were treated by decompression of spinal canal with resection inferior articular process（unilateral or bilateral）,short-segment pedicle screw fixation and posterolateral fusion.1 year follow-up was done to compare JOA changes.Results Average score before surgery was（4.203±0.021）,1 year after surgery was（12.701±0.017）,the difference was statistically significantly different（t=2.438,P=0.035）;excellent 19 cases,good 7 cases and medium 4 cases,excellent and good rate was 86.7%.Conclusion Decompression of spinal canal with resection inferior articular process can reserve the spinal posterior column maximumly（maintaining the stability of the spine）,increase bone cover area for medullispinal,decrease the extradural cicatricial adhesion,and remove the back pain caused by articular process hyperplasia,which is a good method for treating degenerative lumbar spinal stenosis.

关 键 词：腰椎管狭窄症 减压 关节突 内固定 

分 类 号：R678.3[医药卫生—外科学]