椎板间扩大开窗术治疗退变性腰椎管狭窄症

surgical Treatment of Degenerative Lumber Canal Stenosis with Wide Fenestration Decompression

５０例退变性腰椎管狭窄症患者接受了椎板间扩大开窗减压术和神经根管扩大术的治疗，随访１８个月以上，以日本整形外科协会腰痛基准评分：优３０例；良１５例；可２例；差３例。结果提示，多数病人通过扩大开窗术缓解了症状，特别是间歇性跛行、腰痛和下肢根性痛。认为该手术最小限度地切除了必要切除的骨和软组织，而能得到充分的减压效果，对腰椎稳定性损害小，适用于大多数退变性腰椎管狭窄症病例，但对于患节段不稳定的病例，应并用融合固定术。

Fifty patients of degenerative lumar canal stenosis were treated with interlaminal wide fenestration decompression and foraminotomy,and were followed up at least 18 monthes.The results were excellent in 30 cases,good in 15cases,fair in 2 cases,and poor in 3 cases according to JOA lumbago criterion.Most cases successfully relieved their symptoms,especially intermittent claudication,lumbago and radiculalgia.The authors thought that the procedure removed minimal necessary bone and soft tissue,but offered suficient decompression,and less harm to lumbar stability.It was suitable for most cases of degenerative lumbar canal stenosis,but those with unstable involved segments,posteriolateral fusion and/or instrumentation should be carried out simultaneously.