后路椎间盘镜下手术治疗老年性腰椎管狭窄症初步体会  

作　　者：罗万荣[1] 易伟宏[1] 李夏林[1] 刘东宁[1] 王敏[1] 王尔天[1] 

机构地区：[1]广东医学院附属南山医院脊柱外科,广东深圳518052

出　　处：《湖南中医药大学学报》2016年第A01期490-491,共2页Journal of Hunan University of Chinese Medicine

基　　金：广东省自然科学基金S2012010008531

摘　　要：目的探讨后路椎间盘镜下手术治疗老年行椎管狭窄手术方法并评价其临床疗效.方法回顾 2009 年 9月- 2014年 10 月我院收治的老年性腰椎管狭窄症 39 例患者,其中腰3/4节段2例 腰4/5节段20例 腰5/骶1节段17例,患者均在椎间盘镜下行椎管减压术,根据视觉模拟量表（visual analogue scale,VAS）评分、Oswestry功能障碍指数问卷表（ODI）及Nakai 分级进行术前及术后的疗效评价.结果39例患者获得8-35个月的随访,平均随访20个月,通过术前及术后VAS、ODI的比较,症状改善明显,按照Nakai 分级进行疗效评价 其中优28例、良9例,可2例,优良率 94.9%.结论后路椎间盘镜在老年性椎管狭窄症的治疗上能够达到开放手术的目的,对脊柱结构稳定性破坏小,术后恢复快、疗效满意,是治疗老年性椎管狭窄症的一种新的有效的微创手术方式.ObjectiveDiscussing the surgery method and evaluating the clinic effects of degenerative senile lumbar spinal stenosis treated with microendoscopic discectomy（MED）. Methods From Sep.2009 to Oct. 2014, our hospital cured 39 cases illed with degenerative senile lumbar spinal stenosis, which included 3 / 4 lumbar segment in 2 cases ,4 / 5 lumbar segments in 20 cases and L5 / S1 segment in 17 cases. These patients were coped with laminectomy by MED .According to VSA,ODI and Nakai ,we compared the effects before the sugery and after in grading. Results39 patients were followed up for 8-35 months（20 momths in average）.Through comparing the symptoms and effects before and after surgery by VAS and ODI, we found the symptom significantly reduced after the surgery. According to the Nakai classification, the therapeutic effect was evaluated in 28 cases, good in 9 cases, good in 2 cases, excellent and good rate was 94.9%. ConclusionTo the degenerative senile lumbar spinal stenosis,MED can reach the equal effects with open operation , besides, it lightly damaged the stability of spinal structure .The patients recovered faster and satisfied with the effects by MED. So, MED is a new and effective minimally invasive surgery treating the degenerative senile spinal stenosis.

关 键 词：椎间盘镜 腰椎管狭窄症 老年人 微创手术 

分 类 号：R2[医药卫生—中医学]