51例高龄腰椎间盘突出症的手术治疗探讨

目的探讨高龄腰椎间盘突出症的手术治疗方法和疗效。方法对51例患者术前临床症状及影像学进行分析，行后路减压，椎间盘髓核摘除，神经根管、侧隐窝扩大、植骨、椎弓根钉内固定术。结果本组病人手术前，出院时和随访的结果均参考JOA治疗评价标准，对其功能及疗效进行评价，结果为：优39例（76．46％），良8例（15．64％），可3例（5．88％），差1例（1．96％），总优良率为（92．10％）。结论高龄腰椎间盘突出症的手术治疗过程中，必须始终注意处理好减压，植骨融合和内固定三方面的问题，忽略神经根管、侧隐窝的处理将导致手术效果不佳甚至失败。

Retrospect of Operative Treatment to 51 Senile Cases with Lumbar Disc Herniation

Objective： To evaluate operative treatment to lumbar disc herniation in senile patients. Method： 51 lumbar disc herniation cases with pre-operative clinical symptoms and radiography materials were analyzed. The operation was done with the manner of posterior decompres- sion, discectomy, enlargement of nerve root canal and lateral recess, bone graft and pedicle screw fLxation. Results： JOA criteria was used in point ofpre-operation, discharge and follow-up. The outcome was excellent in 39 cases（76.46%）, good in 8 cases（l 5.64%）, general in 3 cases （5.88%）, poor in one case（1.96%）. Excellent and good rate were 92.10%. Conclusion： In the surgical treatment of lumbar disc hemiation in senile patients, decompression, bone graft and internal fixation are three aspects of most concern. Failure may be due to ignorance of decompres- sion of nerve root canal and lateral recess.