老年退行性腰椎管狭窄症不同手术方式的选择及疗效对比分析  

Selection of surgery way and curative effect analysis of senile degenerative lumbar spinal stenosis disease

作　　者：周全[1] 胡兆洋[1] 张大刚[1] 游红林[1] 王超[1] 

机构地区：[1]广安市人民医院骨科,四川广安638000

出　　处：《颈腰痛杂志》2016年第5期392-395,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的研究老年退行性腰椎管狭窄症不同手术方式的选择及疗效对比。方法选取我院2012-11-2014-2间诊治的老年退行性腰椎管狭窄患者70例,根据患者意愿将其分为对照组和观察组,每组各35例,对照组患者采用单纯椎管扩大减压治疗,观察组患者采用减压植骨短节段椎弓根螺钉系统内固定治疗,术后均给予2年的随访,比较两组患者的临床治疗效果。结果观察组患者手术时间和术后下床所需时间明显较对照组短,术中出血量明显较对照组少,差异具有统计学意义(P<0.05);两组患者术后VAS得分均较术前有不同程度的改善,术前术后的差异具有统计学意义(P<0.05);在运动功能恢复情况方面,观察组治疗的总有效率为94.29%,对照组为91.43%,两组差异无统计学意义(P>0.05);在术后并发症发生率方面,观察组患者为11.43%,对照组为11.43%,两组并发症发生率均较低,差异无统计学意义(P>0.05)。结论对于老年退行性腰椎管狭窄患者,根据不同患者的具体情况选择适合其病症的手术方式,均可获得较为满意的效果。Objective To study the senile degenerative lumbar spinal stenosis disease treatment with different surgery way and the curative effect. Methods From November 2012 to February 2014, 70 elderly patients with degenerative lumbar spinal stenosis in our hospital were selected. According to the random number table method, they were divided into observation group and control group, 35 cases in each group. The control group was treated by simple vertebral canal expanded decompression treatment, the observation group was treated by decompression and bone short segmental pedicle screw system internal fixation treatment. The two groups were followed up for two years. The clinical therapeutic effect of two groups was compared. Results The operation time and postoperative bed time in observation group were significantly shorter than those in control group. The amount of bleeding in operation in observation group was less than that in control group, and the difference was statistically significant （P〈0.05）. In terms of preoperative and postoperative VAS score, two groups had different degrees of improvement, the differences were statistically significant （P〈0.05）. In motor function recovery, the total effective rate of observation group was 94.29%, that of control group was 91.43%, there was no significant difference between the two groups （P〉0.05）. The incidence rate of postoperative complications of observation group was 11.43%, that of control group was 11.43%, the incidence rate of complication rate was low in both two groups, there was no statistically significant difference （P〉0.05）. Conclusion For elderly patients with degenerative lumbar spinal stenosis, should according to the specific conditions of different patients to choose operation method, suitable to the condition of a relatively satisfactory results can be obtained.

关 键 词：退行性腰椎管狭窄 椎管 螺钉内固定 椎弓根 

分 类 号：R681.55[医药卫生—骨科学]