老年性腰椎管狭窄症的手术治疗

目的:评价腰椎管扩大成形术在老年性腰椎管狭窄症手术中的应用价值。方法:对81例老年退变性腰椎管狭窄患者,使用特制限深椎板骨刀后路切开椎管减压。43例单纯退变性腰椎管狭窄,仅行椎管扩大椎板关闭成形手术;38例复杂性腰椎管狭窄患者,采用减压椎板关闭成形加钉棒系统内固定。结果:所有患者腰腿痛症状减轻或消失,随诊73例,随访时间6月至6年,平均2年7月。回植关闭的椎板棘突愈合。按日本矫形外科协会(JOA)下腰痛评分标准,优良率87.7%。结论:该手术操作减压彻底,临床疗效满意,脊柱稳定性好,能有效地预防术后硬膜外瘢痕粘连,是治疗老年性腰椎管狭窄症的一种理想方法。

The surgical treatment of senile people with degenerative lumbar vertebral canal stenosis

Objective:To evaluate the clinical value of luminoplasty for senile people with degenerative lumbar vertebral canal stenosis. Methods:81 cases of senile people with degenerative lumbar spinal stenosis were treated, using the special depth-limited bone knife, cut vertically the lamina and decompressed the canal thoroughly. 43 cases of typical degenerative lumbar spinal stenosis were treated only by laminoplasty. Another 38 cases with complex lumbar vertebral canal stenosis were treated by laminoplasty combined with pedicle screws system fixation. Results:73 cases were followed up for 6 months to 6 years(averaging 2 years and 7 months), the signs of lumbar and lower extremities were alleviated or disappeared. All the reduced lamina and spinous process healed. According to JOA(Japanese Orthopaedics Association) score of spine, the rate of excellent and good was 87.7%. Conclusion:This operative approach is easy to decompress thoroughly, it can supply intrinsic stability of spine, and minimize the postoperative epidural adhesion. It is an ideal and adjuvant method for senile lumbar vertebral canal stenosis.