摘要
[目的]探讨退行性腰椎管狭窄症患者手术方式及疗效。[方法]回顾性分析1999~2008年间,手术治疗并获得随访的87例退变性腰椎管狭窄症患者。术前根据患者症状、体征及影像学检查结果确定手术方式。其中39例患者行椎板间开窗、椎管及侧隐窝潜形扩大术。48例患者行全椎板切除、椎管减压＋椎弓根内固定＋后外侧植骨融合术。术后临床疗效采用JOA评分、OD I量表进行评估,运用SF-36调查问卷对患者治疗前和末次随访时生活质量变化情况进行评价。[结果]所有87例患者平均随访38个月。术后所有患者临床症状缓解,行走能力提高,生活质量改善。术前JOA评分平均15.2分,末次随访时平均25.4分（P〈0.05）。术前OD I评分平均61.7分,末次随访时平均48.8分（P〈0.05）。SF-36调查问卷表中的8个维度,各项分值术后较术前相比,均有明显提高（P〈0.05）。[结论]手术减压是治疗退行性腰椎管狭窄症患者的主要目的,术前存在脊柱不稳、预计手术可能破坏脊柱稳定性等情况下,实施融合内固定术可获得满意疗效。
[Objective]To investigate the surgical treatment and clinical effects in degenerative lumbar spinal stenosis. [Methods]Eighty-seven patients with degenerative lumbar spinal stenosis treated by surgery from 1999 to 2008 were reviewed retrospectively.According to their clinical manifestations and radiographic findings,39 patients were treated with only decompression,and the other 48 patients treated with posterior decompression with instrumented fusion.The clinical outcomes were evaluated by Japanese Orthopedic Association（JOA）,Oswestry Disability Index（ODI）and SF-36.[Results]The mean follow-up period was 38 months.The low back pain was relieved significantly,and the life quality was improved clearly after operation.JOA scores decreased from 15.2 points before surgery to 25.4 after surgery,ODI scores decreased from 61.7 points before surgery to 48.8 after surgery.According to the SF-36,all domains of the quality of life in patients were significantly increased（P0.05）.[Conclusion]The effective decompression is the main purpose for treatment of degenerative lumbar spinal stenosis.If there is spinal instability before surgery,and the stability maybe destroyed by treatment,a posterolateral fusion with pedicle screw fixation should be performed.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2011年第7期529-532,共4页
Orthopedic Journal of China
关键词
退行性腰椎管狭窄症
减压
内固定
疗效
degenerative lumbar spinal stenosis
decompression
internal fixation
clinical efficacy
