全椎板切除减压内固定术治疗退行性腰椎管狭窄症

目的探讨腰椎后路全椎板切除减压,椎间自体植骨,椎弓根螺钉固定治疗退行性腰椎管狭窄症的疗效。方法 2006年3月~2009年7月收治退行性腰椎管狭窄症患者62例,所有患者均行腰椎后路全椎板切除减压,摘除相应节段的椎间盘,椎间植入自体骨,椎弓根螺钉固定减压节段。临床疗效采用JOA评分进行评估。结果 62例患者共减压134节段,固定134节段,所有减压节段均行椎间自体骨植骨。所有患者术后均获随访,平均21.3(15~34)个月。手术疗效根据日本骨科学会(JOA)下腰痛手术疗效标准(15分法)进行评分。62例患者中疗效达到优50例,良9例,可2例,差1例,优良率95.16%。结论腰椎后路全椎板切除减压椎间植骨椎弓根螺钉固定治疗退行性腰椎管狭窄症是一种有效的手术方法。

The Decompressive Lamineetomy Combined with Internal Fixation in the Treatment for Degenerative Lumbar Stenosis

Objective To investigate the therapeutic effects of decompressive laminectomy and interverte- bral autograft combined with pedicle screw fixation in the treatment of degenerative lumbar stenosis. Methods From March 2006 to July 2009, 62 cases of degenerative lumbar stenosis were treated with decompressive laminectomy and diskectomy of narrow segment and intervertebral autograft fusion and combined with pedicle screw fixation of decompressive segment. Japanese Orthopedic Association （JOA） score system was used to evaluate clinical effects. Results Decompression and fixation of 134 segments were performed on the 62 cases. Intervertebral autograft fusion was performed on the decompressive segments. All the patients were followed up. The follow-up period was 15 ～ 34 months, 21.3 months in average. The surgical criterion of therapeutic effects （15 points） of JOA about low back pain was used to evaluate surgical effect. According to JOA score standard, there were 50 cases of excellent, 9 cases of good, 2 cases of fair and 1 case of poor. The excellent rate was 95.16%. Conclusions It is an effective surgical method with decompressive laminectomy and intervertebral autograft and pedicle screw fixation for the treatment of degenerative lumbar stenosis.