老年骨质疏松引起椎管狭窄症的原因及治疗方法（附61例报告）

Cause and Treatment for Spinal Canal Deriving from Senile Osteoporosis

因老年骨质疏松椎间盘髓核中蛋白粘多糖及水份的减少，纤维环松弛、椎间隙变窄、椎间盘膨出，加上黄韧带肥厚皱折，后纵韧带钙化增生、使椎管容积缩小是造成颈、腰椎管狭窄的主要原因。８年来收治颈、腰椎管狭窄症６１例。最大年龄７６岁，最小年龄５８岁，对颈椎管狭窄症采用颈后路单开门椎管扩大成形术，本法优点既保护大部椎板起保护脊髓的作用，又起到椎管扩大充分减压的作用。对腰椎管狭窄症采用保留关节突、棘突完整取下，将椎管扩大见神经根不受压，将取下的棘突横盖在椎板缺损处，棘突两侧用七号丝线各缝二针，固定在关节突韧带或椎板上。本法优点既可防腰肌与硬脊膜粘连又起到融合增强脊柱的稳定性。术后，经１一８年随访结果，除２例原有严重腰１，粉碎型压缩骨折马尾神经损伤后遗症外，其余５９例均获满意效果，优良率达９６．７％。

n senile osteoporosis patients,the nucleus pulposus of their intervertebral disc lost proteoglycanand water.so the fi-brous ring laxed,the intevertebral space narrowed, and intevertebral disc protruseiJ. In addition,the yellow ligament foldedand thickened, postetior longitudinal ligament calcificated and hyperplased. As a result, cervical and lumbar spinal canalstenosis occured. For cervical spinal canal stenosis,we use pcaterior cervieal sigle openning enlatgement and plastic opera-tion. This method can not only save most part of vertebral lamina, but also make a satisfactory decompression. For lumbarspinal canal stenosis,we cut off the whole spinous process, retain the ariicular process. and remove the vertebral lamina,thenenlarge the spinal canal till the nerve root can't be cornpressed. Finally, we cover the vertebral defecting site with the spinousprocess. The advantage of this method is that it can avoid the adhesion and conjunction of lumbar muscle and dura mater ofspinal cord , and increase the stability of spinal column.In recent eight years.61 patients (aged from58 to 76)with cervicalaed/or lumbar spinal canal stencosis were treated by these methods. The petiod of postoperative follow- up studies variedfrom 1 to 8 yeare. The rate excellent and good tesults was 96.7%