摘要
目的:探讨腰椎管狭窄症的手术减压指征、减压范围及内固定选择。方法:回顾性分析腰椎管狭窄症患者259例,平均年龄52.2岁,平均病程4年1个月。根据病情分别采用椎板间节段开窗潜行减压术139例,腰椎管内径扩大成形术63例,全椎板切除减压、椎间植骨融合内固定术57例。结果:221例获得平均4年2个月随访。三种手术方法优良率分别为91.53%、87.50%和85.45%;手术并发症发生率为13.69%、15.87%和20.11%。结论:对严重的腰椎管狭窄症若手术适应证和减压范围掌握恰当,不论采取何种手术方式的神经减压术,均可取得满意疗效。正确选择病例和熟练的外科技术是应用内固定器械的重要条件。
Objective:Through the analysis of 259 cases of lumbar spinal stenosis treated by operation the surgical decompression and internal fixation were evaluated.Method:The average age of the 259 patients was 52.2 years,the average history was 4 years and 1 month.They main complaint was pain in back and in one or two legs,numbness in the involved legs.They all had the symptom of neuragenic claudication.202 cases were examined with CT?CTM and/or MRI,62cases were examined with myelography except the X-ray plate.91cases complicated with protrusion of intervertebral disc.89 cases occurred at one level of L4-5 or L5-S1.76 cases at two levels of L4-5 and L5-S1 or L3-4 and L4-5.81 cases occurred at three levels.13 cases at four levels and more.Group Ⅰconsisted of 139 cases of degenerative lumber spinal stenosis were treated with decompression of spinal canal by undercutting the laminae through the interspace of laminae.GroupⅡ consisted of 63 cases,operations were performed by enlargement of interior radius lumbar spinal canal of Group Ⅲ consisted of 57 cases were treated with laminectomy,intervertebral fusion and internal fixation.Result:221 cases were followed up and the average followed-up was 4 years and 2 months.The satisfactory rate of the three groups was 91.53%,87.50% and 85.45%,and the incidence of complications was 13.69%, 15.87% and 20.11% respectively.Conclusion:The result of the spinal canal decompression for the treatment of lumber spinal stenosis are satisfactory.Strict indication and perfect surgery are the key to reduce the rate of complications,and select cases and skilled technique are the important measures for successful internal-fixation operation.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2003年第1期18-21,共4页
Chinese Journal of Spine and Spinal Cord
