腰椎椎体后缘离断症的临床治疗

目的探讨手术治疗腰椎椎体后缘离断症的疗效及适应证。方法对31例腰椎椎体后缘离断症患者的临床资料进行回顾性分析,应用JOA评分及改善率评价手术治疗效果。结果随访3～4年,JOA评分术前为14.67分±2.08分,术后3个月为24.84分±4.43分,差异有统计学意义(P<0.01);末次随访时为27.58分±2.12分,与术后3个月时比较差异无统计学意义(P>0.05)。末次随访时手术满意程度:优27例,良2例,可2例,优良率为93.5%。随访期内间盘组织全切组与未全切组临床效果比较差异无统计学意义(P>0.05)。结论手术治疗腰椎椎体后缘离断症疗效满意。马尾综合征及足下垂是绝对手术适应证;术中需根据具体情况选择性切除间盘组织及关节突并尽可能保证脊柱稳定性。

Clinical treatment of posterior bony edges separation of lumbar vertebrae

Objective To study the surgical treatment indications of posterior bony edges separation of lumbar vertebrae and its clinical effect.Methods 31 cases of posterior bony edges separation of lumbar vertebrae were treated and its clinical data were retrospectively analyzed.Each patients′ preoperative and postoperative status was evaluated based on the Japanese Orthopedic Association(JOA) functional scales.Results Follow-up period ranged from 3 to 4 years,The preoperative JOA score was 14.67±2.08.When followed by 3 months,the score changed into 24.84±4.43,there was statistical significance between them(P<0.01).At the end of follow-up,the JOA score was 27.58±2.12 without significant difference compared with cases of 3 months postoperatively.Satisfaction with the end of follow-up surgery: excellent in 27 cases,good in 2 cases,fair in 2 cases,and excellent and good results were 93.5%.Total disc resection group and subtotal group were no difference between the clinical results(P>0.05).Conclusions Surgical results are satisfactory.Cauda equina compression and foot drop is absolutely surgical indications;surgery depending on the circumstances require selective removal of the discs and facet joints and tissue as possible to ensure stability of the spine,usually without bone graft fusion and internal fixation.