选择性关节突周围减压结合改良TLIF治疗退变性腰椎管狭窄症

The application of articular process decompression and modified transforaminal lumbar interbody fusion in degenerative lumbar spinal stenosis

目的探讨选择性关节突周围减压、结合改良TLIF、椎弓根钉固定治疗退变性腰椎管狭窄症的治疗效果。方法采用选择性关节突周围减压、结合改良TLIF、椎弓根钉固定治疗退变性腰椎管狭窄症患者22例,男14例,女8例,平均年龄63.5岁;融合单节段8例,双节段10例,三节段4例。结果全部患者均安全完成手术,未出现严重并发症。经6个月～2年(平均13月)随访,术前症状及体征均缓解,脊柱融合率达90.9%,未发生植入骨的吸收、移位和沉陷。本组疗效优13例,良6例,可3例,优良率86.3%。结论选择性关节突周围减压、结合改良TLIF、椎弓根钉固定是一种有效治疗退变性腰椎椎管狭窄症的手术方法,并且创伤相对小,恢复快,经济适用,尤其适合于基础医院。

Objective To examine the clinical outcomes of patients with a degenerative lumbar spinal stenosis treated by the way of selective articular process decompression,modified transforaminal lumbar interbody fusion and transverterbal pedicle Internal fixation.Methods There were 22 patients（14 male,8female） with an average age of 63.5 years.All patients underwent articular process decompression,modified transforaminal lumbar interbody fusion and transverterbal pedicle Internal fixation.The interbody fusion one levels is 8 patients,two levels 10 patients,three levels 4 patients.Results All patients underwent surgery safely without severe complications occurred.The average following up time was average 13 months（6months ～ 2years）.The preoperative symptoms and signs were released.The spinal fusion rate was 90.9%.No graft absorption,displacement or collapse was found.The clinic results：excellent 13 patients,good 6 patients,fair 3 patients.86.3 % of the patients obtained successful clinical outcome.Conclusion The way of selective process decompression,modified transforaminal lumbar interbody fusion is a sound,useful procedure to the treatment of degenerative lumbar spinal stenosis,especialy to the basic hospital for its less trauma,economicer and quicker restore.