摘要
目的探讨腰椎减压融合术中采取健侧预防性减压的必要性和可行性。方法 1 147例接受腰椎减压融合术的腰椎管狭窄症患者,按时间段分为非预防组(732例)和预防组(415例),预防组根据术前健侧腰椎椎管狭窄程度选择性行健侧预防性减压。分析两组术后健侧腰源性腿痛的发生率和再手术率。结果非预防组腰椎术后发生健侧腰源性腿痛27例,发生率3.69%,其中19例经保守治疗后好转,8例需再次手术,再手术率1.09%;预防组术后发生健侧腰源性腿痛11例,发生率2.65%,均为预防组中根据标准无需预防减压的患者,其中9例经保守治疗后好转,2例再次手术,再手术率0.48%。术后健侧腰源性腿痛的发生率和再手术率预防组均低于非预防组,差异均有统计学意义(P<0.05)。结论对术前腰椎MRI显示健侧严重狭窄或中度狭窄且曾有过下肢症状的患者,行健侧预防性减压可以降低术后健侧下肢痛的发生率和腰椎再手术率。
Objective To evaluate the necessity and feasibility of contralateral preventive decompression in the surgi-cal treatment of lumbar canal stenosis.Methods 1 147 cases of lumbar canal stenosis underwent lumbar spine de-compression and fusion surgeries were divided into non-preventive group （n=732）and preventice group （n=415） by different stages.For the preventive group,contralateral preventive decompression was performed according to the severity of stenosis that preoperative MRI showed.The postoperative contralateral leg pain rate caused by lumbar spine and reoperation rate were recorded and analyzed.Results There were 27 cases had contralateral leg pain after operation in the non-preventive group,the leg pain rate was 3.69%.19 cases were cured by conservative treatment and the other 8 cases underwent revision surgeries,the reoperation rate was 1 .09%.For the preventive group,1 1 ca-ses had contralateral leg pain after operation,the leg pain rate was 2.65%.9 cases were cured by conservative treat-ment and 2 cases need revision surgery.The reoperation rate was 0.48%.There was significant difference of the postoperative leg pain rate and revision rate between two groups（P〈0.05 ）.Conclusions Contralateral preventive decompression in lumbar spinal stenosis patients reduce the rate of postoperative contralateral leg pain caused by lum-bar spine and rate of reoperation.
出处
《临床骨科杂志》
2014年第2期146-148,共3页
Journal of Clinical Orthopaedics
关键词
腰椎管狭窄症
腰椎融合术
健侧预防减压
腿疼
lumbar canal stenosis
lumbar fusion
contralateral side preventive decompression
leg pain
