退变性腰椎管狭窄手术治疗的临床研究

Clinical research of surgical treatment of degenerative lumbar spinal stenosis disease

目的探讨退变性腰椎管狭窄症(LSS)手术指征、手术方式的选择及合并症的处理。方法对32例腰椎管狭窄合并不稳定性腰椎退变性滑脱选择全椎板切除、侧隐窝及椎间孔减压、椎弓根螺钉固定、椎体间及小关节后外侧植骨术,术后随访,评价手术效果。结果 32例均获随访,时间8个月～6年。采用参照Amundsen评分标准评价术后疗效,优21例,良8例,可3例,无差级病例。结论根据患者的临床症状、体征及影像学综合考虑其诊断及其合并症来选择手术减压的范围和植骨融合和(或)内固定与否,从而改善临床症状,提高其生活质量。

Objective To analyze and summarize surgical indications,operation methods selection and complications of treatment in degenerative lumbar spinal stenosis disease（LSS）.Methods Totally 32 cases with lumbar spinal stenosis merger instability lumbar degenerative spondylolisthesis choose omni-posterior excision,side fossae and intervertebral foramen decompression,vertebral pedicle screw,small joints between vertebral bodies and the poster lateral using bone graft,follow-up and evluat operation effect.Results All cases were followed up for 8 months to 6 years.The results were evaluated in accordance with the standard of Amundsen,which were excellent in 21 cases,good in 8,fair in 3,no difference magnitude cases.Conclusions According to the clinical symptoms,signs and considering its diagnostic imaging and its complications to choose the scope and surgical decompression of bone fusion and（or） inside fixed or not,so as to improve the clinical symptoms,improve their quality of life.