摘要
[目的]探讨改良腰椎管扩大成形术治疗老年多节段腰椎管狭窄症(lumbar spinal stenosis,LSS)的临床疗效。[方法]回顾性分析本院2020年2月—2022年12月行改良腰椎管扩大成形术治疗的35例老年多节段LSS患者的临床资料,评价临床及影像资料。[结果]所有患者均顺利完成手术,无严重并发症。平均随访(23.9±9.2)个月,与术前相比,术后3个月及末次随访时腰痛VAS评分[(4.8±1.3),(1.5±0.7),(1.4±0.5),P<0.001]、腿痛VAS评分[(6.9±1.1),(2.5±0.7),(2.3±0.6),P<0.001]及ODI评分[(90.0±20.0),(10.0±10.0),(10.0±10.0),P<0.001]均显著降低,平地连续行走距离[(183.7±114.4)m,(817.1±108.4)m,1212.9±175.5)m,P<0.001]显著增加。影像方面,与术前相比,术后3个月及末次随访时椎管面积[(1.3±0.1)cm^(2),(1.8±0.1)cm^(2),(1.8±0.1)cm^(2),P<0.001]及侧隐窝矢状径[(3.0±0.5)mm,(5.4±0.6)mm,(5.5±0.6)mm,P<0.001]均显著增加。[结论]改良腰椎管扩大成形术治疗老年多节段LSS临床疗效满意,是一种安全可行的治疗方法。
[Objective]To investigate the clinical efficacy of the modified enlarging laminoplasty for multi-level lumbar spinal stenosis(LSS)in elderly.[Methods]A retrospective study was conducted on 35 elderly patients who received the modified enlarging laminoplasty for multi-level LSS in our hospital from February 2020 to December 2022.The clinical and imaging data were evaluated.[Results]All patients were successfully operated on without serious complications,and were followed up for a mean of(23.9±9.2)months.With time preoperatively,3 months postoperatively and the last follow-up,the low back pain VAS score[(4.8±1.3),(1.5±0.7),(1.4±0.5),P<0.001],leg pain VAS score[(6.9±1.1),(2.5±0.7),(2.3±0.6),P<0.001]and ODI scores[(90.0±20.0),(10.0±10.0),(10.0±10.0),P<0.001]were significantly declined,whereas the continuous walking distance on flat land[(183.7±114.4)m,(817.1±108.4)m,(1212.9±175.5)m,P<0.001]significantly increased.As for imaging,spinal canal area[(1.3±0.1)cm^(2),(1.8±0.1)cm^(2),(1.8±0.1)cm^(2),P<0.001)and sagittal diameter of lateral recess[(3.0±0.5)mm,(5.4±0.6)mm,(5.5±0.6)mm,P<0.001]were significantly increased over time.[Conclusion]This modified enlarging laminoplasty is a safe and feasible method for the treatment of multi-level LSS in elderly and achieves satisfactory clinical consequence.
作者
娄纪刚
李鹏飞
滕元平
戴磊
姜岩
LOU Ji-gang;LI Peng-fei;TENG Yuanping;DAI Lei;JIANG Yan(Department of Orthopaedics,The First Affiliated Hospital,Zhengzhou University,Zhengzhou,Henan 450000,China)
出处
《中国矫形外科杂志》
北大核心
2025年第5期464-467,共4页
Orthopedic Journal of China
基金
河南省医学科技攻关计划项目(编号:LHGJ20210349)。
关键词
老年
多节段腰椎管狭窄症
棘突韧带复合体
椎管扩大成形
elderly
multilevel lumbar spinal stenosis
spinous process and ligament complex
lumbar enlarging laminoplasty
