手术治疗退变性腰椎管狭窄症及不稳

目的:观察手术方法治疗退变性腰椎管狭窄症合并腰椎不稳的疗效.方法:2001年1月～2003年1月治疗退变性腰椎管狭窄症合并腰椎不稳定共48例,平均年龄55.7岁,病程1～12年,平均4.5年.全部病例经后路全椎板切除减压、椎弓根螺钉系统内固定及横突间植骨融合手术治疗,其中1个节段椎管减压8例,2个节段减压35例,3节段减压5例.结果:术后随访平均14月(6月～24月),按日本矫形外科协会(JOA)下腰痛评分标准,优良率92%.植骨融合未发现骨不连或假关节形成.结论:手术治疗退变性腰椎管狭窄症合并腰椎不稳可以达到满意疗效.术中减压应彻底,植骨融合对后期腰椎的稳定性有重要作用,应注重植骨床的准备和植骨量.

The operation in treatment of degenerative lumbar spinal stenosis and instability of the lumbar segments

Objective: To observe the curative effect with operation in treatment of degenerative lumbar spinal stenosis and instability of the lumbar segments. Methods: Forty-eight cases were treated with posterior decompression,pedical screw system fixation and bone grafting lumbar fusion in the transverses from Jan.2001 to Jan.2003. The average age was 55.7 years old and the average course of diseases was 4.5 years (range 1-12 years) .All cases were decompressed including 8 cases in one lumbar segment, 35 cases in two segments and 5 cases in 3 segments. Results: They were followed up 14 months (range 6 ~ 24 months) after operation. The excellent and good rates were 29% according to JOA(Japanese Orthpaedics Association) score.There were no non-union cases and pseudarthrosis cases after grafting. Conclusion: It will obtain a excellent results with operation in treatment of degenerative lumbar spinal stenosis and instability of the lumbar segments.We emphasize that extensive decompression and lumbar fusion are very important.