显微镜下手术治疗退变性腰椎管狭窄症

Microscope-assisted decompression for degenerative lumbar spinal canal stenosis

目的:评价显微镜下手术减压治疗退变性腰椎管狭窄症的临床效果。方法:2006年1月～2006年12月在显微镜下行手术减压治疗退变性腰椎管狭窄症患者36例,单节段13例,双节段23例。术前及术后8个月时应用ODI(Oswestry disability index)评分法对患者进行评定,并进行综合满意度评估。结果:均顺利完成手术,单节段手术时间60￣180min,平均85min,出血50￣130ml,平均73ml;双节段手术时间70￣180min,平均95min,出血50￣150ml,平均80ml。术中4例患者发生硬膜破裂,予以相应处理后痊愈,术后无神经根损伤、感染及腰椎失稳等并发症发生,所有病例均获得8个月以上随访,术前ODI评分平均78.22±17.62分,术后8个月时平均30.17±15.26分,Wilcoxon秩和检验手术前后ODI评分差异显著(P<0.05)。手术综合满意程度评估,优28例,良5例,可3例,优良率92%。结论:显微镜下手术减压治疗退变性腰椎管狭窄症可以获得良好的疗效。

Objective：To evaluate the clinical results and features of microscope-assisted decompression for lumbar degenerative spinal canal stenosis.Method：36 patients of degenerative lumbar spinal canal stenosis（ 13 patients with single segment and 23 patients with double segments） treated with microscope-assisted decompression from January 2006 to December 2006 were reviewed,all patients were evaluated by ODI（Oswestry disability index） （Version 2.0） before operation and 8 months after operation,and by the rate of general satisfaction to the operation as well.Re.stilt：All the cases were operated successfully.The time of operation for the patients with single segment was 60-180 minutes,average 85 minutes,blood loss 50-130ml,average 73ml.Time of operation for the patients with double segment was 70-180 minutes,average 95 minutes,blood loss 50- 150ml,average 80ml.4 cases were suffered from endorachis rupture,which healed after corresponding treatment. There was no other complications such as nerve root injury,infection,spine destabilizing. All the patients were followed up at least 8 months.Pre- and post-operative ODI score were 78.22±17.62 and 30.17±15.26 respectively.There were statistically significant differences in pre- and post-operation ODI score using the Wilcoxon＇s rank sum test.Satisfaction rate for the treatment was excellent in 28 cases,good in 5 cases,fair in 3 cases and no poor.The excellent and good rate was 92%.Conclusion：Microscope assisted decompression for degener- ative lumbars pinal canal stenosis can get a satisfactory therapeutic effect.