退行性腰椎管狭窄症的微创治疗  

Minimally invasive treatment of degenerative lumbar spinal stenosis

作　　者：何佳佳[1] 龚智标 刘通[1] 朱涛[1] 

机构地区：[1]天津医科大学总医院神经外科,天津300052

出　　处：《天津医科大学学报》2016年第3期259-261,共3页Journal of Tianjin Medical University

摘　　要：目的：探讨采用椎板间入路治疗退行性腰椎管狭窄症的临床效果。方法：回顾性分析采用微创椎板间入路治疗183例退行性腰椎管狭窄症患者的临床资料,观察手术时间、术中出血量及并发症发生情况,采用疼痛视觉模拟量表（VAS）评分和日本骨科学会（JOA）评分评估临床效果。结果：183例患者手术时间平均（51±10.5）min;术中出血量平均（12±2.5）m L,其中单节段单侧神经根减压120例,单节段双侧减压32例,多节段减压31例。所有患者均无硬脊膜损伤、神经根损伤及椎间隙感染等并发症。183例患者有效随访165例,总随访率90.2%,随访6-34个月,平均18.4个月。术后不同手术类型患者末次随访VAS及JOA评分显著高于术前,具有显著统计学差异（P〈0.05）。结论：微创椎板间入路手术能有效治疗退行性腰椎管狭窄症。Objective： To investigate the clinical outcomes and surgical techniques of nerve root decompression approach for lumbar spinal stenosis. Methods：Retrospective analysis was applied on minimal invasion between vertebral plates in the treatment of 183 cases with degenerative lumbar spinal stenosis disease, and the operation time, intraoperative blood loss and complications were observed. The assessment was performed using the Japanese Orthopaedic Association（JOA）, Visual Analogue Scale（VAS） at 6 months and 1 year after the operation. The parameters were recorded such as the operation time, intraoperative blood loss, postoperative complications, hospital stays and etc. Results：The surgical results were good. The preoperative VAS and JOA scores were significantly improved at 6 months and 1 year after the surgery. Conclusion：Minimally invasive surgery between vertebral plates can be effective in the treatment of degenerative lumbar spinal stenosis disease.

关 键 词：腰椎管狭窄 微创 神经根减压术 

分 类 号：R744[医药卫生—神经病学与精神病学]