开窗减压手术治疗腰椎管狭窄症的临床研究

目的探索一种无需重建稳定性的减压手术治疗腰椎管狭窄症。方法共152例腰椎管狭窄症患者,随机序贯分为2组,A组行改良开窗减压手术,B组行传统全椎板减压手术,评价术前与术后的腰痛、下肢放射痛、行走耐受性和神经系统功能恢复。结果A组病例总的疗效优为89％,良为11％;B组病例总的疗效优为63％,良为30％,差为7％。结论改良开窗手术对于退变性腰椎管狭窄症,即使合并轻度的先天性腰椎管狭窄,其减压的效果也是足够充分有效的,且术后长期效果满意,并发症少,医疗费用低,可以作为治疗无术前腰椎失稳的退变性腰椎管狭窄症（可合并轻度先天性腰椎管狭窄）的标准手术,在临床上推广。

The clinical study of the surgical treatment with the posterior column reservation for lumbar spinal stenosis

Objective To explore a more effective and less invasive decompression technique without instrument and fusion for lumbar spinal stenosis. Methods This prospective study included 152 consecutive patients, who were sequentially divided into 2 groups, and underwent windows technique (Group A) and decompressive laminectomy (group B). The patients were followed up and evaluated by back pain, leg pain, walking tolerance and neurological recovery pre-operatively and post-operatively. Results The overall results of Group A were good to excellent in 89% of the patients, fair in 11%. The overall results of group B were good to excellent in 63% of the patients, fair in 30%, and poor in 7%. Conclusion Degenerative spinal stenosis can be decompressed adequately by preserving the posterior elements. The "Windows technique" laminoforaminotomy, which obtained satisfactory long-term outcomes with few complications and low cost, can be a standard procedure for the surgical treatment of the degenerative spinal stenosis even with slight congenital spinal stenosis.