后路减压、固定、融合治疗骨质疏松症合并腰椎管狭窄症

Decompression,fixation,and fusion treatment for osteoporosis combine with lumbar vertebra stenosis

目的评估后路减压、固定、融合治疗骨质疏松症合并腰椎管狭窄症的疗效。方法 2007年1月至2009年1月,收治骨质疏松症合并腰椎管狭窄症患者32例,男,12例,女,20例,年龄62～80岁,平均74岁。所有患者术前均行X线、CT、MRI及双能X线骨密度(BMD)检查。患者采用后路减压、固定、融合手术进行治疗。术后进行随访,采用VAS,SF-36评分系统进行疗效评估。结果手术时间121～165 min,平均130 min,出血量400～600 mL,平均510 mL。所有患者均获得随访,随访时间6个月～3年6个月,平均2.4年。术前、术后VAS评分分别7.1±1.6,3.2±1.9。术后有1例患者跌倒致连接杆断裂,经手术取出,重新安装。结论后路减压、固定、融合手术是治疗骨质治疏松症合并腰椎管狭窄症的有效手段。

Objective To evaluate the efficacy of backward decompression, fixation, and fusion treatment for osteopurosis combined with lumbar vertebral stenosis. Methods From January 2007 to January 2010, 32 patients with osteoporosis combined with lumbar vertebral stenosis were treated in our hospital. There were 12 males and 20 females. They were 62-80 years old, with an average of 74 years old. X-ray, CT, MR, and BMD examination were performed preoperatively for all the cases. VAS and SF-36 score system were used to evaluate the effects. Results The operation time was 121-165 min, 130 min in average. The bleeding amount was 400-600 ml, 510 ml in average. All the patients were followed up. The follow up period was 0. 6-3.6 years, 2.4 years in average. VAS score was 7.1 ±1.6 preoperatively, and 3.2 ±1.9 postoperatively. Pedicle screw breaking occurred in 1 case and it was taken out and reset with operation. Conclusion Backward decompression, fixation, and fusion treatment is efficient for osteoporosis combined with vertebral stenosis.