椎板开窗潜行减压钉棒系统内固定植骨融合术治疗老年退行性腰椎管狭窄症的疗效分析

摘要：目的：探讨椎板开窗潜行减压钉棒系统内固定植骨融合术治疗老年退行性腰椎管狭窄症的临床疗效。方法：回顾性分析2019年1月1日至2020年5月1日我科收治的40例老年退行性腰椎管狭窄症患者，所有患者均采用椎板开窗潜行减压钉棒系统内固定植骨融合术治疗。术后采用X线评估术后脊柱稳定性，视觉模拟评分法(visual analog scale，VAS) 和JOA评分评价临床疗效。结果：患者男 16 例，女 24 例，平均年龄(66.8± 3.19)岁。随访时间段为3月~16个月，均超过12个月，平均13.4个月。术前、术后3个月及术后1年的VAS评分与 JOA 评分分别为：（7.83±1.08）分、（3.10±0.98）分、（2.83±0.64）分；（8.58±1.17）分、（19.98±3.40）分、（21.90±1.60）分；JOA评分优良结果：优12 例，良13例，一般12例，差3例；1年后随访时JOA评分结果：优13例，良 25 例，一般 2 例，差 0 例。术前后比较，疗效显著（P＜0.05）。所有患者无伤口感染、椎体滑脱、术中损伤神经等并发症。结论：椎板开窗潜行减压钉棒系统内固定植骨融合术治疗老年退行性腰椎管狭窄症安全，近期和远期疗效较好，同时术后并发症较少，值得临床研究。

Clinical analysis of decompression, screw rod system internal fixation, bone grafting and fusion in the treatment of senile degenerative lumbar spinal stenosis

Abstract: Objective: To investigate the clinical effect of laminectomy, decompression, screw rod system internal fixation, bone grafting and fusion in the treatment of senile degenerative lumbar spinal stenosis. Methods: 40 elderly patients with degenerative lumbar spinal stenosis treated in our department from January 1, 2019 to May 1, 2020 were analyzed retrospectively. All patients were treated with laminectomy, decompression, screw rod system internal fixation, bone grafting and fusion. The postoperative spinal stability was evaluated by X-ray, and the clinical efficacy was evaluated by visual analog scale (VAS) and JOA score. Results: there were 16 males and 24 females, with an average age of (66.8 ± 3.19) years. The follow-up period ranged from 3 months to 16 months, with an average of 13.4 months. Preoperative The VAS score and JOA score at 3 months and 1 year after operation were: (7.83 ± 1.08), (3.10 ± 0.98), (2.83 ± 0.64), (8.58 ± 1.17), (19.98 ± 3.40) and (21.90 ± 1.60) points; JOA score excellent results: excellent in 12 cases, good in 13 cases, fair in 12 cases and poor in 3 cases; JOA score results at one-year follow-up: excellent in 13 cases, good in 25 cases, fair in 2 cases and poor in 0 cases. The curative effect was significant before and after operation (P < 0.05). All patients had no complications such as wound infection, spondylolisthesis and intraoperative nerve injury. Conclusion: laminectomy, decompression, screw rod system internal fixation, bone grafting and fusion in the treatment of senile degenerative lumbar spinal stenosis is safe, with good short-term and long-term effects, and less postoperative complications, which is worthy of clinical research.