保留脊柱后部结构的椎板切除减压术治疗腰椎管狭窄的研究

A study of modified laminectomy with the spinal posterior structure preserved in the treatment of lumbar spine stenosis

目的对比研究保留后部结构的改良全椎板切除减压术和传统全椎板切除减压术对腰椎管狭窄患者术后的症状及腰椎稳定性影响。方法对2003年5月-2004年5月因腰椎管狭窄症需行椎板切除减压手术治疗的患者48例,采用随机分组的方法分为实验组(26例)和对照组(22例),分别采取保留后部结构的改良全椎板切除减压术和传统全椎板切除减压术,术后1年和3年随访手术疗效及脊柱稳定性。结果术后1年发现两组腰椎稳定性无明显差别。术后3年发现两组症状改善无明显差别,但实验组腰椎稳定性显著高于对照组。结论保留后部结构的改良全椎板切除减压术的远期手术疗效满意,在腰椎管狭窄的手术中应尽量保留腰椎的后部稳定结构。

Objective To comparatively study the influence of modified laminectomy with the spinal posterior structure preserved and the traditional laminectomy on spine stability of patients with lumbar spine stenosis. Methods 48 patients with lumbar spine stenosis underwent laminectomy decompression between May 2003 and May 2004. All patients were randomized into the experiment group （n：26） and the control group （n=22）. The experiment group underwent modified laminectomy with the spinal posterior structure preserved, while the control group underwent traditional laminectomy. All patients were followed up 1 and 3 years after surgery for the efficacy and spine stability. Results No significant difference of spine stability was seen between the experiment group and the control group 1 year after surgery. 3 years after surgery, no significant difference of symptom improvement was found between 2 groups, but the spine stability of the experiment group was better than that of the control group. Conclusions The modified laminectomy with the spinal posterior structure preserved showed satisfactory long-term outcomes. It should be more often used for lumbar spine stenosis.