老年腰椎间盘突出症的临床特点与手术治疗体会

目的探讨老年腰椎间盘突出症的临床特点和手术效果。方法对24例60岁以上腰椎间盘手术患者的临床资料进行回顾性分析。手术方法采用单侧或双侧扩大开窗、扩大神经根出孔术17例，半椎板切除术4例，全椎板切除术3例。结果24例随访平均2．4年，有效率为91．7％。但60～69岁年龄组与70岁以上年龄组相比，后者疗效有所下降（P〈0．01）。结论老年腰椎间盘突出症的发病特征是高位间隙和多节段病变比例增加，建议对非手术治疗无效的老年患者应积极手术治疗。

Clinical characteristics and operation effect of lumbar disk herniation in elderly

Objective To investigate the pathological and clinical characteristics and the effect of operation in the lumbar disc herniation (LDH) of the elderly.Methods The clinical data of the operated 24 patients aged over 60 years old with LDH were retrospectively analyzed.Operations included unilateral or bilateral extended fenestration in17 ,the hemilaminectomy in 4 patients,the laminectomy in 3.ResultsAll the 24 patients were followed up for an average of 2.4 years.The exeellent and good rate was 70.8% and the effective rate was 91.7% according to the M-JOA score.The curative effect in the group of patients with more than 70 years old group was lower than that in the group of patients between 60 and 69 years old(P ＜ 0.05).Conclusions The characteristics of the disease in the elderly are the increase of the proportion of upper segments and multispaces.The patients receiving the conservative treatment without effect should undergo the operation.