退行性腰椎滑脱伴腰椎管狭症的手术治疗

目的探讨退变性腰椎滑脱伴椎管狭窄症的手术治疗。方法回顾性分析 84例退变性腰椎滑脱伴腰椎管狭窄症的手术治疗结果。其中男性 33例 ,女 5 1例 ;年龄 4 3～ 79岁 ,平均 5 6 .1岁 ;包括Ⅰ°滑脱 5 1例 ,Ⅱ°滑脱 33例。33例接受单侧或双侧椎板开窗减压术 ,5 1例接受全椎板切除减压、植骨融合椎弓根螺钉内固定术。结果 84例经过平均 5年 3个月的随访 ,两种手术方法疗效优良率分别是 90 .90 %、84 .2 7% ,两种疗效无显著性差别 (P >0 .0 5 )。手术并发症发生率为 9.0 9%、17.6 4 % ,亦无显著性差异 (P >0 .0 5 )。结论对于腰椎管狭窄症伴腰椎滑脱症手术适应症和减压范围要掌握恰当 ,二种手术方式减压均可以取得满意疗效。

Surgical treatment of lumbar spinal stenosis associated with degenerative spondylolishthesis

Objective To assess the surgical treatment of lumbar spinal stenosis associated with degenerative spondylolisthesis. Methods A total of 84 patients (33 male and 51 female, aged from 23 to 79 years) with lumbar spinal stenosis associated with degenerative spondylolisthesis were retrospectively studied. Of these, 61 cases were in degree 1 and 23 cases were in degree 2. 33 cases were treated with decompression of spinal canal by laminotomy unilaterally or bilaterally. While 51 patients were treated with laminectomy, posterolateral fusion and internal fixation with pedicle screw system. Results All cases were followed-up for 5 years and 3 months in average. The satisfactory rates of the two treatments were 90.90% and 84.27% respectively. The possibilities to develop the complication during the surgeries were 9.09% and 17.64% respectively. Conclusion The results of the spinal canal decompression for the treatment of lumbar spine stenosis are satisfied. Strict indication and adequate techniques in the surgery are the keys to reduce the occurring of complications.