半椎板切除减压术与全椎板切除减压内固定植骨融合治疗腰椎管狭窄症的对比研究

Comparative study of the lumbar spinal stenosis treated by unilateral laminectomy and total laminectomy interbody fusion combined with internal fixation

目的比较半椎板切除减压术与全椎板切除减压内固定植骨融合术治疗腰椎管狭窄症的疗效。方法将48例腰椎管狭窄症患者随机分为A、B两组,A组26例,采用半椎板切除减压术,B组22例,采用全椎板减压内固定植骨融合术,观察比较两种方法术中出血量、手术时间、临床疗效评价的差异。结果 A组的术中出血量明显少于B组(t=14.95,P<0.01),手术时间也明显短于B组(t=25.57,P<0.01);A组术后优良率为80.77%,B组术后优良率为81.82%,二者差异无统计学意义(χ2=0.01,P>0.05)。结论两种术式治疗腰椎管狭窄临床效果均良好,但半椎板切除椎管减压术术中出血量较少及手术时间较短。

Objective To compare the clinical effect of unilateral laminectomy and total laminectomy interbody fusion and internal fixation in the treatment of lumbar spinal stenosis. Methods Forty-eight patients with lumbar spinal stenosis were divided into two groups, group A （n=26, treated by unilateral laminectomy） and the group B （n=22, treated by total laminectomy interbody fusion and internal fixation）. The two groups were compared in terms of blood loss, operation time, and clinical effect. Results In group A, the blood lose was significantly less than that in group B （t=14.95, P0.01）, and the mean operative time was significantly shorter （t=14.95, P0.01）. The excellent and good rate was 80.77% in group A and 81.82% in group B, showing no statistically significant different between （χ2=0.01, P0.05）; Conclusion Although the two surgical methods are both effective in the treatment of lumbar spinal stenosis, unilateral laminectomy is preferred because of significantly less blood loss and shorter operation time.