彻底减压、内固定和椎体间融合术治疗退行性腰椎管狭窄症

目的探讨退行性腰椎管狭窄症经彻底减压、经椎弓根内固定和椎体间融合术治疗的效果。方法采用彻底减压、经惟弓根内固定及椎体间融合治疗23例退行性腰椎管狭窄症。结果随访12～36个月，平均24．5个月，所有患者腰痛伴臀部或下肢疼痛消失，跛行改善，下肢感觉16例恢复，7例部分恢复；鞍区麻木伴大小便失禁的患者3例，鞍区麻木恢复2例，不恢复1例，大小便失禁术后1年3例均逐步恢复。结论在退行性腰椎管狭窄症治疗中，彻底减压是手术关键，行椎弓根内固定术，可以稳定脊柱，同时作椎体间植骨融合，保证手术成功。

Treatment of degenerative lumbar stenosis with complete decompression, internal fixation and interbody fusion

Objective To investigate the effect of complete decompression, transpedicle internal fixation and interbody fusion for degenerative lumbar stenosis. Methods 23 cases with degenerative lumbar stenosis were treated with complete decompression, transpedicle internal fixation and interbody fusion. Results All cases were followed up for 12 -36 months, 24. 5 on average. All lower back pain and associated buttock or leg pain disappeared. The claudication was improved. 16 cases got lower limbs sense complete recovery., and 7 got partial recovery. In 3 cases with saddle numbness and urine incontinence, 2 got saddle numbness recovery, while 1 did not; The urine incontinence was improved in 1 year. Conclusions In the treatment of degenerative lumbar stenosis, complete decompression is the key, transpedicle internal fixation and interbody fusion can restore the spinal stability.