摘要
腰椎管狭窄症的治疗原则不仅考虑彻底解除神经组织的压迫，还要兼顾保持脊柱的稳定性，尽最大可能不遗留腰椎不稳造成的腰痛等并发症。回顾分析1997-2005年间上海交通大学医学院附属第三人民医院和上海长征医院获得随访的181例退变性腰椎管狭窄症临床资料。男103例，女78例，年29～87岁，平均58．3岁，病程5个月-21年，平均45月。治疗中内固定采用sofamor公司、Depuyspine公司生产的材料。根据患者检查结果选择手术方式：A组：全椎板切除＋根管扩大29例。B组：半椎板切除＋根管扩大24例。C组：椎板间开窗＋根管扩大43例。D组：全椎板切除减压＋椎弓根钉内固定＋横突间植骨52例。E组：全椎板切除减压＋椎弓根钉内固定＋横突间植骨＋椎间融合33例。181例随访均大于1年，平均51个月，5种手术方式优良率分别为75．9％，83．3％，79.1％，86.6％，90.9％，并发症发生率分别为18.6％，11．1％，15．4％，20．1％，18.8％。实验结果显示，椎体间植骨恢复了脊柱生理高度，提高了融合率，降低了手术后疾病复发率、融合后断钉断棒率。
Nervous tissue compression and spinal stability are important in treating lumbar spinal stenosis to reduce low back pain or other lumbar instability-caused complications. One hundred and eighty-one cases of lumbar spinal stenosis undergoing surgery in Third People＇s Hospital of Shanghai Jiao Tong University Medical School and Shanghai Changzheng Hospital between 1997 and 2005 were investigated retrospectively. They consisted of 103 males and 78 females, with an average age of 58.3 years （range, 29-87years） and mean disease course of 45 months （range 5 months to 21 years）. The fixation and fusion materials were from Sofamor and Depuy Spine. According to the examination results, 29 cases were treated with complete laminectomy and foraminotomy; 24 treated with hemilaminectomy and foraminotomy; 43 with fenestration and foraminotomy; 52 with decompression and internal fixation and bone graft fusion between transversal process, and 33 with decompression and internal fixation and bone graft fusion between vertebral body. 181 patients were followed up for more than 1 year with a mean follow-up period of 51 months. The satisfactory rate of 5 surgery methods were 75.9%, 83.3%, 79.1%, 86.6%, and 90.9%. The incidence of complications was 18.6%, 11.1%, 15.4%, 20.1%, and 18.8%, respectively. The results of the study indicate that intervertebral body fusion and internal fixiation restore spinal physiologic height, improve fusion rate, and reduce postoperative recurrence and screw or rod breakage rates after fusion.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第22期4291-4294,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
