全椎板切除脊柱内固定用于老年退行性腰椎管狭窄症治疗的临床观察

目的观察全椎板切除脊柱内固定术治疗老年退行性腰椎管狭窄症的临床疗效。方法选取2007年5月～2011年12月我院收治54例老年退行性腰椎管狭窄症患者为研究对象,所有患者均行全椎板切除加脊柱内固定手术治疗,观察患者手术后疗效以及X线表现的改变。结果①本组术后1个月时椎体间相对距离为0.812±0.048,与术前比较有所增加,差异有统计学意义(P<0.05);椎体间矢状面活动角度、椎体间冠状面活动角度和椎体间水平面活动角度手术前后变化不明显,差异无统计学意义(P>0.05)。②术后疗效,优29例,良18例,中7例,优良率为87.04%。术后随访1～3个月,X线检查显示植骨均融合,内固定未见松动或断裂。结论全椎板切除减压脊柱内固定术治疗老年退行性腰椎管狭窄症,在正确掌握适应症的情况下,可获得满意的效果,既可实现彻底减压的目的,又能维持术后脊柱稳定性。

The clinical observation of laminectomy and spinal internal fixation treatment for older degenerative lumbar spinal stenosis disease

Objective To observe the clinical effects of laminectomy and spinal internal fixation treatment for older degenerative lumbar spinal stenosis disease.Methods From May 2007 to December 2011,54 cases of elder patients with degenerative lumbar spinal stenosis disease were selected as the research object,all of patients were given laminectomy and spinal internal fixation treatment,with observing the curative effect and X-ray performance change after surgery.Results ①one month after surgery,the relative distance of adjacen vertebral bodies was 0.812±0.048 which was higher than the preoperative,the comparing difference was statistical significance(P<0.05),The difference of vertebral activities angle at the sagittal view,coronal plane and horizontal plane before and after operation was not change significantly,comparative differences was not statistically significant(P>0.05).②In this group of patients,the optimal curative effect was 29 cases,the good curative effect was 18 cases,and the mid curative effect was 7 cases,the rate of optimal and good curative effect was 87.04%.Follow-up of 1~3 months,X-ray showed that bone graft fused,internal fixation had not found the loose and rupture.Conclusion Under the correct grasp indication,laminectomy and spinal internal fixation treatment for older degenerative lumbar spinal stenosis disease can get satisfactory effect,achieve the purpose of completely unwind,and maintain the postoperative spinal stability.