改良骨刀截骨椎板棘突复合体回植治疗腰椎管狭窄症  

Improved bone knife spinous lamina osteotomy replantation complex treatment of lumbar spinal stenosis

作　　者：丁慧勇[1] 侯彦杰[1] 阿布力米提.阿木提 

机构地区：[1]新疆医科大学第二附属医院骨科,新疆维吾尔自治区乌鲁木齐市830063

出　　处：《临床外科杂志》2017年第3期216-218,共3页Journal of Clinical Surgery

摘　　要：目的分析改良骨刀截骨椎板棘突复合体回植治疗腰椎管狭窄症的疗效。方法腰椎管狭窄症患者56例,所有患者均采取改良骨刀截骨椎板棘突复合体回植治疗,复查CT,测量术前及末次随访的椎管矢状径、椎管横径,观察预后及并发症,并按照日本骨科学会下腰痛评分标准(Japanese orthopaedics asso ciation,JOA)评价临床疗效。结果 56例患者末次随访时椎管矢状径、椎管横径均较术前明显扩大;JOA评分较术前明显提高,差异有统计学意义(P<0.05);临床疗效优良率为96.43%;所有患者CT复查显示,椎板原位融和率为100%,无腰椎不稳、继发性腰椎管狭窄症、椎板棘突复合体移位、下陷、脱落等并发症;6个月基本达到骨性愈合。结论改良骨刀截骨椎板棘突复合体回植治疗腰椎管狭窄症疗效确切,可有效重建腰椎后部结构的稳定性、完整性,减少并发症发生。Objective To improve bone knife spinous lamina osteotomy replantation complex treatment of lumbar spinal stenosis patients. Methods Retrospective analysis from January 2014 to January 2015, the clinical data of 56 patients with lumbar spinal stenosis disease, all patients were taken modi- fied osteotome bone cutting composite lamina spinous process and implant treatment, through follow-up, the CT, preoperatie and follow-up sessions at the end of the measurement of vertebral canal sagittal diameter, spinal canal diameter, to observe the prognosis and complications, and according to the Japanese orthopae- dic society of low back pain score standard（Japanese orthopaedics asso ciation,JOA）, the rate of good e- valuation of clinical curative effect. Results This group of 56 patients with lumbar spinal stenosis disease, the last follow-up, vertebral canal sagittal diameter, spinal canal diameter, than preoperative significantly increased; JOA score was obviously improve the preoperative; The t test, statistically significant difference（P 〈 0.05 ） ; The rate of good clinical curative effect was 96.43% ; Follow-up period, all patients by CT review that lamina in situ fusion rate was 100% , no lumbar spinal instability, secondary lumbar spinal stenosis, composite lamina spinous complications such as shift, subsidence, fall off; 6 months basic achieve bony healing. Conclusion The modified bone knife spinous lamina osteotomy replantation complex therapeutic effect of lumbar spinal stenosis precise, effective reconstruction of posterior structure stability, integrity, reduce complications, the prognosis is good, worthy of clinical use .

关 键 词：腰椎管狭窄症 椎板 棘突 回植 

分 类 号：R687.31[医药卫生—骨科学]