老年性腰椎间盘突出症的外科治疗(附31例报告)

目的探讨老年性腰椎间盘突出症的发病特征,外科治疗方法及疗效.方法对31例患者进行手术治疗,方法为全椎板切除+小关节内侧切除术,同时行侧隐窝减压,神经根管扩大,突出间盘组织摘除,以松解神经根.结果31例经过2个月～3a的随访,按照中华骨科学会脊柱学组腰腿痛手术评定标准评定均取得满意疗效.结论术前应行脊髓造影检查,必要时行CT检查,手术应彻底减压,术式应采用全椎板切除+小关节内侧切除术,同时行侧隐窝减压及神经根管减压,彻底松解神经根.

Surgical treatment of the elderly with protrusion of the lumbar intervertebral discs(A Review of 31 Cases)

Objective:To analys the elderly with protrusion of the lumbar intervertebral discs were analysed and we discussed the methods of diagnosis and surgical treatmentMethods:Thirtyone patients with protrusion of the lumbar intervertebral discs were treated by surgical operation 48 protrusion of nucleus pulposus were resectedResults:Thirtyone cases had excellent or good outcome by 2~36 months followup The results of treatment were satisfactory Preoperation diagnosis was proved by pathological diagnosis Conclusion: Myelography, CT and MRI examination were applied before operation in order to know clearly lumbar canal condition During operation, we found elderly with protrusion of the lumbar lntervertebral discs often companied with lumbar canal stenosis, lateral recess stenosis, nerveroot pathway stenosis, edema and adhesion of nerveroot, hypertrophic ligamentum flavum So total laminectomy and resection of medial portion of the articular process, lateral recess and nerveroot pathway decompression were performed to release nerveroot completely