摘要
目的:总结高龄腰椎管狭窄症患者的手术效果,评价其手术耐受性。方法:对57例年龄大于70岁的腰椎管狭窄症患者的术前伴发疾病、术后全身和局部并发症及其处理进行总结,对45例获得6～58个月随访的患者采用日本骨科学会(JOA)29分法对术前和随访时的神经功能和生活能力进行评分,计算改善率,并对结果进行统计学分析。结果:术后出现的全身并发症包括心功能不全、心律失常、脑梗塞等,局部并发症有脑脊液漏和伤口积液。45例患者随访时的平均改善率为60.2%,手术疗效不佳的患者占8.9%。病程在2年之内者与病程大于2年者的改善率无显著性差异;术前评分在10分之内者与大于10分者的改善率亦无显著性差异。结论:高龄腰椎管狭窄症患者在严格控制伴发疾病,积极处理术后并发症的情况下,能够取得良好的手术效果。
Objective：To study the surgical outcome of lumbar spinal canal stenosis in the elderly and evaluate their tolerance to surgical treatment.Method：Preoperative associated diseases,postoperative complications and treatment were summarized in 57 patients over 70-year-old who underwent surgery for lumbar spinal canal stenosis.45 patients were followed up for 6～58 months.Their neurological functions and self-care abilities were evaluated by using JOA 29 grading system preoperatively and at 6 to 54 months postoperatively,and improving rate was analyzed statistically.Result：General complications included cardiac insufficiency,arrhythmia, cerebral infarction ,stress ulcer and disorder of electrolytes and acid-base equilibrium.Local complications were cerebrospinal fluid leakage and wound hydrops.The mean improving rate of 45 patients was 60.2%,and dissatisfaction rate was 8.9%.In patients whose course was less than 2 years,the improving rate was higher than that of patients with the course more than 2 years,but had no statistical difference.There was no significant difference of the improving rate between patients whose preoperative JOA points was below 10 and above 10. Conclusion：If the associated disorders are strictly controlled and postoperative complications are treated positively,surgical method can be a favorable procedure for the elderly.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2005年第8期479-482,共4页
Chinese Journal of Spine and Spinal Cord
关键词
腰椎管狭窄症
手术效果
高龄
Lumbar spinal canal stenosis
Surgical outcome
Elder
