高龄腰椎管狭窄症的手术治疗评估策略  

Surgical strategy for lumbar spinal stenosis of elderly patients

作　　者：李华[1] 王立涛[1] 

机构地区：[1]河北省衡水市哈励逊国际和平医院

出　　处：《颈腰痛杂志》2016年第5期400-403,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的分析腰椎管狭窄症在高龄人群的临床特点,探讨针对此类患者的手术治疗策略,以期提高手术疗效。方法选择2009-01-2012-01本院治疗的67例65岁以上的高龄腰椎管狭窄症患者,依据导致腰椎管狭窄的病因、分型及合并症情况,分别采取椎板开窗、全椎板切除椎管减压、全椎板切除椎管减压并植骨融合及椎间孔镜微创手术等手术方式,加强围手术期管理,观察症状改善情况。结果 67例患者均手术顺利,安全渡过围手术期,术后67例患者均获得随访,平均18个月。治疗效果优良率86.57%。结论高龄患者出现腰椎管狭窄症具有特殊临床特点,应针对患者的不同情况,采用个体化手术治疗方案,精准减压,减小手术副损伤,重视脊柱稳定性的保护,可取得满意手术效果。Objective To analyze the disease characteristics and to investigate the surgical strategy for lumbar spinal stenosis of elderly patients in order to improve the surgical therapy efficacy. Methods 67 cases aged above 65 years old were treated from January 2009 to January 2012. According to different factors by which the lumbar canal stenosis caused,different kind of surgical methods were used such as relieving neurologic compression by laminotomy,or partial laminectomy, or whole laminectomy,some cases were treated by spinal canal decompression and intervertebral fusion, meanwhile perioperational management was emphasized. The surgical therapy efficacy was judged according to lumbar back pain surgical standard of spinal surgery group of Chinese orthopaedics association. Results Surgical procedure was successful. All patients passed through perioperational period safely,67 cases of them were followed- up,and the following- up time was 18 months on average,the excellent and good rate of therapy was 86.57%. Conclusion Satisfactory result can be achieved by analyzing the disease characteristic,paying attention to perioperational management, emphasizing the balance of efficient decompression and spine stability during surgery,and applying individual surgical method according to the disease characteristic which caused lumbar stenosis.

关 键 词：高龄患者 腰椎管狭窄症 内科合并症 术式选择 

分 类 号：R681.55[医药卫生—骨科学]