选择性开窗潜行减压治疗退行性腰椎管狭窄症

目的 探讨退行性腰椎管狭窄治疗的手术方式。讨论本病的病理特点和采用选择性开窗潜行减压这一术式的可行性。方法 对６３例退行性腰椎管狭窄症患者，根据其术前ＣＴ等的定位、定性、定量及术中的具体所见，针对性地选择一侧或双侧，单个或多个开窗，行潜行减压治疗，并观察其后期疗效。结果 经治疗的６３例患者，开窗潜行减压基本上达到了满意的减压效果。疗效达优２７例，占４２．８％。良３３例，占５２．４％；可３例，占４．

Treatment of degenerative lumbar spinal canal stenosis with selective fenestration decompression

Objective:To describe a surgical method for the treatment of degenerative lumbar canal stenosis,to study its pathologic features and to discuss the procudure of selective fenestration decompression.Methods:63 cases of degenerative lumbar canal stenosis were treated with one or double,single or multilevel widened fenestration decompression according to the location,nature and size of the stenosis shown in the pre operative CT examination and the intra operative findings.The post operative outcome were observed.Results: All the patients obtained effective decompression following widened fenestration.The outcome was excellent in 27 cases (42.8%),good in 33 cases (52.4%),fair in 3 cases (4.5%)and poor in none.Conclusion:The widened fenestration included different modes of fenestrations,minimal resection of vertebral laminal and articular process,stripping and extirpating of degenerative and hypertrophic ligamentum flava and intervertebral discs.It could maintain spinal stability with effective decompression and avoid iatrogenic lumbar canal stenosis and lumbar spondylolisthesis.