综合康复疗法治疗高龄退行性腰椎管狭窄症的观察

目的：探讨康复疗法治疗高龄退行性腰椎管狭窄症的有效性及其特点。方法：研究组100例患者。采用综合保守方法进行治疗，对短期疗效进行随访观察。设立对照组对治疗效果进行比较分析，对照组选取本院同期内因腰椎管狭窄症施行手术的患者56例。结果：研究组随访1年，治疗前JOA点数7～24点，治疗后12～29点，平均好转率为56．5％；治疗前出现间歇性跛行的距离为10～500m，治疗后为350～1000m，平均RIC为46．5％；治疗前平均VAS6．5，治疗后为2．4，随访1年后为1．9。对照组手术前JOA点数7～18点，手术后10～29点，平均好转率59．7％；手术前出现间歇性跛行的距离为0～500m，手术后为400～1000m，平均RIC为47．2％，两组比较差异无统计学意义。结论：综合康复治疗可作为治疗腰椎管狭窄症的方法之一，对不能接受手术的高龄患者的短期疗效是可靠的。

Rehabilitation in the treatment of elderly patients with degenerative lumbar spinal stenosis

Objective:To evaluate the efficacy of rehabilitation in the elderly patients with degenerative lumbar spinal stenosis. Methods:We reviewed a study group of 100 patients aged between 70 and 85 who had accepted non-operation between 2000 and 2007. In all cases clinical symptoms were gait disorders involving intermittent claudication and lumbago with bilateral or unilateral sciatica. The control group 56 patients had been performed surgery with decompression or instrumentation between 2000 and 2007. Results: The average clinical recovery rate for all 100 patients was 56.5% and pain level was 2.4 (on a visual analogue scales of 1 to 10), while the average pain level at 12 months follow-up was 1.9. The recovery rate of intermittent claudication was 46.5%. The average clinical recovery rate for control group was 59.7%. There was no significant difference of the recovery rate between study and control group. Conclusion:Our data indicate that Rehabilitation has been an effective and safe procedure for degenerative lumbar spinal stenosis in elderly patients whose physical status is not always suitable for surgery.