颈椎和腰椎并发椎管狭窄症Ⅰ期手术减压的临床疗效

目的　观察Ⅰ期手术减压治疗颈腰椎并发的椎管狭窄症的疗效及其安全性。 方法　回顾22例Ⅰ期手术减压治疗颈、腰椎并发的椎管狭窄症的临床资料及围手术期并发症，平均年龄(68.7±9.3)岁(55～83岁)，随访24～58个月，记录手术时间、出血量、住院时间；术前、术后1月和随访末期JOA评分（颈椎17分法、腰椎29分法）及其改善率；患者满意度；并分析围手术期并发症。 结果　平均手术时间、失血量、住院时间分别是（189±49）min、（490±70）ml、15.9 d；随访末期JOA改善率分别达到67.9%（C-JOA）、63.5%（L-JOA）,较术前显著改善（P <0.05），病人满意度73.9％；围手术期并发症发生率18.1%，包括急性失血、脑脊液漏、深部感染、短暂性神经损害各1例。 结论　Ⅰ 期手术减压治疗颈腰椎并发的椎管狭窄症疗效满意；围手术期并发症并未因此增加，但应严格手术指征。

The anatomic feature and Clinical outcomes of one-staged decompression for patients with combined cervical and lumbar stenosis

Objective　To evaluate clinical outcomes and safety of one-staged combined cervical and lumbar decompression for patients with tandem spinal stenosis. 　Methods　Clinical outcomes and perioperative complications were reviewed in 22 patients who underwent one-staged combined cervical and lumbar decompression retrospectively. The mean age was (68.7±9.3) years(55～83 years).The follow-up period ranged from 24 to 58 months. The JOA score and its recovery rate（cervical-17 points, lumbar-29 points）were recorded before operation, 1 month after surgery, and at the final follow-up.　Results　The mean surgical duration, blood loss, and hospitalization length were (189±49) min、(490±70) ml、15.9 days respectively. The JOA recovery rate were 67.9% for cervical and 63.5% for lumbar at the final follow-up. The improvement degree of JOA scores was significant compared with that of pre-operation. The overall complication incidence were 18.1%, which included acute blood loss anemia 1 case, cerebrospinal fluid leakage 1 case, deep infection 1 case, Transient neurological deficiency 1 case.　Conclusions　One-staged combined cervical and lumbar decompression for TSS can deliver fair results. It is a safe and effective method for this condition.