单节段腰椎退变不稳并神经根管狭窄手术治疗的初步报告

目的 探讨应用腰椎侧后方斜向单枚ＢＡＫ椎间融合器椎间融合及小关节螺钉固定术治疗单节段腰椎退变不稳并神经根和狭窄的治疗效果。方法 采用后路腰椎侧后方对神经根管彻底减压，由侧后方斜向植入单枚ＢＡＫ椎间植骨融合器，再经棘突根部向对侧未减压的小关节植入１枚小关节螺钉固定的方法，治疗单节段腰椎退变不稳并神经根管狭窄患者３０例，男３０例，女１７例，平均年龄４６．５岁；其中融合节段为Ｌ３～４者４例，Ｌ４－５者１

Surgical treatment of single level unstable degeneration with foraminal stenosis

OBJECTIVES: Lumbar spine single level unstable degeneration with foraminal stenosis was treated with unilateral decompression, disc excision, posterolateral interbody fusion utilizing single BAK cage and count-lateral facet joint screw fixation. The short-term and mid-term clinical results were evaluated. METHODS: There were thirty patients (13 male, 17 female) with an average age of 46.5 years. From posterior approach, all patients underwent unilateral decompression, disc excision, interbody fusion with posterolateral inserted single BAK cage, and count-lateral facet joint screw fixation. RESULTS: All patients underwent surgery safely without severe complications occurred such as infection and neurological damages. The average follow-up time was 12 months (6 - 18 months) with complete relief of symptoms. Solid fusion was achieved in all but 2 patients at final follow-up. 90% of the patients obtained successful clinical outcome. CONCLUSIONS: Complete decompression of the neural foramen can relief the symptoms, and interbody fusion utilizing threaded cage can restore the height of disc space and withstand axial loading of the spine. Addition of the facet joint fixation increased the postoperative segment stability and enhances solid fusion. With less invasive and preservation of part of the posterior elements of the lumbar spine and the solid fusion achieved, we consider it a sound procedure for the treatment of single level unstable degeneration with foraminal stenosis of lumbar spine. Long-term follow-up results needs to be observed.