腰椎管狭窄症并腰椎不稳的手术治疗

Lumbar Spinal Stenosis and the Surgical Treatment of Lumbar Instability

目的:探讨腰椎管狭窄症合并腰椎不稳的诊断和治疗。方法:52例腰椎管狭窄症合并腰椎不稳,男31例,女21例,平均年龄58.7岁,采用双侧半椎板有限元减压保留棘突韧带同时加椎弓根螺钉内固定植骨术治疗。结果:随访1.5～4.5年,平均2年7个月,植骨全部愈合,内固定位置正常,但有4例延迟愈合。术前JOA评分平均3.2分,术后平均13.8分,平均改善率89.83%,优良率94.23%。结论:在充分减压的同时保留棘突韧带,提供椎弓根螺钉内固定并植骨,能保持脊柱的稳定性,临床应用疗效肯定。

Objective：To discuss the key point of lumbar spinal channel stenosis surgery and influence of trans-pedicle intemal fixation in the unstable low lumbar vertebra with lumbar spinal stenosis. Methods：52 patients with lumbar spinal stenosis and lumbar instability （31 male,21 female,the mean age was 58.7 years） were undergone decompression and bone graft fusion with a pedicle screw system.Design using finite element bilateral semi-lamineetomy decompression increase at the same time retain the spinous ligament pedicle screw fixation and bone grafting Results：Fifty-two patients were followed up18-54 months （average 31 months）, bone grafting were obtained, fixed position within the normal, However, four cases of delayed healing. The overall mean JOA scores improved from preoperative 3.2 to postoperative13.8 period. The mean recovery ratio was 89.83%,the excellent and good rate was 94.23%.Conclusion： Full decompression at the same time retained the spinous ligament,to provide the pedicle screw fixation and bone glaring, they can rebuild the spine to maintain stability,clinical efficacy sure.