椎板间隙开窗及神经根管潜行减压治疗退行性腰椎管狭窄症  

Treatment of degenerative lumbar canal stenosis by segmental interlaminar fenestration and undercutting of the nerve root canal

作　　者：陈名智[1] 伍骥[1] 董树理[1] 刘志雄[1] 贾光[1] 

机构地区：[1]空军总医院骨科,北京100036

出　　处：《空军总医院学报》2002年第2期73-75,共3页Journal of General Hospital of Air Force,PLA

摘　　要：目的　探讨退行性腰神经根管狭窄的手术治疗方法。　方法　采用单节段或多节段椎板间隙开窗加神经根管潜行减压治疗退行性腰椎管狭窄症 6 5例 ,其中合并腰椎间盘突出症 2 3例。　结果　术后对 5 8例病人进行了 2个月～ 8年 ,平均2 6个月的随访观察 ,优 4 1例 ,良 8例 ,可 7例 ,手术优良率为 84 .5 % ,手术后 3d～ 2周即可下床行走。　结论　该术式特点为保留了完整的棘突、棘上韧带、棘间韧带及部分椎板 ,小关节突内侧有限的切除 ,使后柱的骨性稳定结构得以保存 ;对神经根的减压彻底。Objective The effectiveness of spinal surgery for lumbar canal stenosis was investigated. Methods 65 patients with lumbar canal stenosis, including 23 cases associated with herniated disc, were treated by segmental interlaminar fenestration and undercutting of the nerve root canal. Results 58 patients were followed up by letter questionnaire and outside clinic. Follow up response over a period of 3 months to 8 years showed the results as good in 46 cases and fair in 9 cases, 84.5% of patients do well. All patients left bed after operation on 3～14 days. The patients were satisfied with the improvement of intermittent claudication. Conclusion The advantages of this method are that the spinous processes with superspinous ligaments, interspinous ligaments and part of lamina were preserved. Medial facetectomy of the inferior facet was limited. There was no affection on spinal stability. It may be provided adequate decompression and adequate stabilization. The key of the success is the decompression of nerve roots. Short term follow up data indicate that operative management provides effective relief, but prospective effects that operative interventions on the long term natural history of lumbar spinal stenosis are needed. If instability is present, autogenous intertransverse bone grafting will be recommended.

关 键 词：椎板间隙开窗 神经根管潜行减压 退行性腰椎管狭窄症 椎板切除术 手术方法 

分 类 号：R681.5[医药卫生—骨科学]