退变性腰椎管狭窄合并节段性腰椎不稳定的手术治疗

目的 :观察腰椎管减压、横突间或椎体间植骨脊柱融合和椎弓根螺钉内固定手术治疗退变性腰椎管狭窄合并节段性腰椎不稳定患者的效果。 方法 :回顾性分析总结 1997年 3月～ 2 0 0 4年 2月 31例退变性腰椎管狭窄合并节段性腰椎不稳定患者经椎管减压、横突间或椎体间植骨融合和椎弓根螺钉内固定术后临床症状改善和X线表现。 结果 :术后平均随访 2年 7个月 (6个月～ 5年 ) ,所有患者的症状有不同程度的改善 ;临床疗效 :优 2 3例 ,良 5例 ,可 4例 ,优良率为 87.1%。 结论 :腰椎管减压、横突间或椎体间植骨脊柱融合和椎弓根螺钉内固定治疗退变性腰椎管狭窄合并节段性腰椎不稳定的疗效肯定 ,且应把恢复该节段的稳定作为重点。

Treatment of degenerative lumbar spinal stenosis with segmental instability

Objective: To evaluate the efficacy of decompress lami nectomy, pedicle screw fixation and posterior lumbar fusion in the treatment of degenerative lumbar spinal stenosis with segmental instability. Methods: From March 1997 to February 2004, thirty-one patients of degenerative lumbar spinal stenosis with segmental instability who were treated by decompress laminectomy, pedicle screw fixation and posterior lumbar fusion, were analyzed retrospectively. Results: The patients were followed up from 6 months to 5 years with an average of 2 years and 7 months.The results showed that the pr e-operative clinical symptoms disappeared differently in all of the patients. 87.1% of the patients were obtained successful clinical outcome. Conclusions: Decompress laminectomy, pedicle screw fixation and posterior lumbar fusion were effective ways of treatment in degenerative lumbar spinal stenosis with segmental instability. To restabilized the segmental instability was emphasised.