神经根管减压术治疗腰椎神经根管狭窄症

Nerve root canal reconstruction surgery for treating lumbar lateral recess stenosis

目的探讨神经根管减压术治疗腰椎神经根管狭窄症的临床疗效。方法对25例确诊为腰椎神经根管狭窄症患者行神经根减压术治疗,分别进行术前及术后3、12、24个月VAS和JOA评分,同时进行影像学评价。结果术后VAS逐渐降低,与术前比较差异有统计学意义(P<0.05),随时间延长VAS降低明显;术后各时段间差异比较亦有统计学意义(P<0.05)。术后JOA评分明显增高,与术前比较差异有统计学意义(P<0.05);但术后各时段间比较差异无统计学意义(P>0.05)。术后24个月临床症状改善优良率为84%(22/25)。结论神经根管减压术是建立在熟练掌握神经根解剖特点基础上行椎板有限开窗、对狭窄的神经根管充分减压、椎弓根钉棒系统植骨内固定治疗神经根管狭窄症疗效满意。

Objective To observe the outcome of nerve root canal reconstruction surgery in treating lumbar lateral re- cess stenosis. Methods 25 patients with lumbar lateral recess stenosis were performed nerve root canal reconstruc- tion surgery. The visual analogue scale （VAS） and JOA score results were maintained before and 3, 12 and 24 months after the operation. Results All patients benefited from the operations. The VAS score after the operation were decreased significantly （ P 〈 0. 05） compared to before the operation. JOA score were improved （ P 〈 0. 05 ）, and the differences were not significant between the follow-up intervals. The excellent and good rate was 84% （22/ 25 ）. Conclusions On the base of well understanding the anatomy of lateral recess, the lumbar lateral recess steno- sis can be treated with nerve root canal reconstruction surgery. The satisfied outcome has been observed for 24 months follow-up after the operation.