中老年腰椎间盘突出症伴椎管狭窄的手术治疗和术后康复  

Surgical treatment and postoperative rehabilitation of lumbar disc herniation acompanied by stenosis in the elderly

作　　者：张向阳[1] 周泰仁[1] 曹德良[1] 

机构地区：[1]上海市长宁区中心医院骨科,200336

出　　处：《上海医学》2000年第12期756-758,共3页Shanghai Medical Journal

摘　　要：目的　探讨提高中老年腰椎间盘突出症伴腰椎管狭窄手术效果和术后康复治疗的方法。方法　回顾总结 1995年 3月至 1999年 12月手术治疗 40周岁以上腰椎间盘突出症伴椎管狭窄 2 80例的情况 ,重点探讨术中扩大开窗减压、预防性减压法和术后早期康复治疗的方法。结果　按照中华骨科学会脊柱外科学组1993年评定标准 ,本组术后复发 2例 ,椎间盘炎 1例 ,本组优 2 32例 ,良 2 9例 ,可 7例 ,没有无效病例 ,优良率93 .78%。结论　中老年腰椎间盘突出症往往伴有一定程度的腰椎管狭窄的退行性变化 ,手术治疗是一种比较适宜的治疗方法 ;术中要充分减压 ,对对侧和相邻节段隐窝狭窄需作预防性扩大减压术 ,以减少后期因腰椎管狭窄引起的神经根受压症状 ;它对腰椎术后稳定性并无影响 ;根据手术中减压和组织损伤情况指导病人进行康复训练是十分重要的 ,是确保手术效果的必要手段。Objective To appraise the efficacy of surgical treatment and postoperative rehabilitation of lumbar disc herniation accompanied by lumbar stenosis in the elderly. Methods From Mar 1995 to Dec 1999, 280 patients underwent surgical treatment and postoperative rehabilitation, with adequate decompression of vertebralis canal and prophyactic decompression if necessary. Results 268 patients were followed up, among whom two recurred, one had discitis, and 98.9% showed improvement. Conclusion For elderly patients with lumbar disc heriation accompanied by lumbar canal stenosis, surgery is a better choice and the key element is adequate decompression of canals vertebralis, which has no influence on lumbar spine stability; Also rehabilitation training is another essential factor for elderly patients. (Shanghai Med J, 2000,23∶756-758)

关 键 词：腰椎盘突出症 手术 减压 康复 

分 类 号：R681.5[医药卫生—骨科学]