保留后方韧带复合体的两种不同椎板减压术治疗腰椎管狭窄症并腰椎不稳  

A study of two kinds of laminectomy with the spinal posterior structure preserved in the treatment of lumbar spine stenosis with lumbar instability

作　　者：郁有来[1] 赵德勇[1] 李强[1] 陈向阳[1] 袁峰[1] 郭开今[1] 

机构地区：[1]徐州医学院附属医院骨科,221002

出　　处：《齐齐哈尔医学院学报》2016年第11期1437-1438,共2页Journal of Qiqihar Medical University

摘　　要：目的比较保留后方韧带复合体有限开窗潜式减压融合内固定术和保留后方韧带复合体全椎板减压融合内固定术对腰椎管狭窄症并腰椎不稳患者的治疗效果。方法对按同一标准选择的32例腰椎管狭窄症并腰椎不稳患者进行前瞻性研究,根据入院顺序随机分为两组。A组(16例)行保留后方韧带复合体有限开窗潜式减压植骨融合内固定术,B组(16例)行保留后方韧带复合体全椎板减压植骨融合内固定术。比较两组平均手术时间、平均出血量、并发症、脊髓神经功能状态、植骨愈合率并进行统计学分析。结果 B组平均手术时间、出血量明显高于A组;术后6月两组JOA评分均较术前明显提高;两组之间的改善率无显著性差异(P>0.05);植骨全部融合,并发症发生率无显著性差异(P>0.05)。结论两种术式均取得了良好的临床效果,保留后方韧带复合体有限开窗潜式减压融合内固定术节约手术时间,创伤相对较小。Objective To analyze the efficacy of two kinds of laminectomy with the spinal posterior structure preserved in the treatment of lumbar spine stenosis with lumbar instability. Methods A prospective study was carried out and 32 cases of lumbar spine stenosis with lumbar instability were accepted by the same selection criteria,they were randomly divided into two groups. Group A were done through modified laminectomy with the spinal posterior structure preserved,bone fusion and internal fixation,Group B through total laminectomy with the spinal posterior structure preserved,bone fusion and the internal fixation. Compared average operation time,volume of bleeding,complication occurrence,bone fusion rate,and nerve function. Results The average operation time and volume of bleeding of Group B were higher than Group A. The JOA score of each group was markedly improved than the preoperative at 6 months. There was no significance about the rate of improvement between the two groups（ P〉0. 05）. Bone fusion rate were both 100%. The complication rate was no significant difference（ P〉0. 05）. Conclusions Two surgeries have both achieved good clinical efficacy,however,modified laminectomy can be less trauma.

关 键 词：腰椎管狭窄症 后方韧带复合体 减压 内固定 

分 类 号：R681.5[医药卫生—骨科学]