显微镜下一侧入路双侧减压治疗老年腰椎管狭窄

The bilateral decompression under microscope via unilateral approach for the lumbar spinal stenosis in elder patients

目的探讨采用显微镜下一侧入路双侧减压治疗老年腰椎管狭窄的安全性和有效性。方法回顾分析2008年1月至2011年1月24例70岁以上腰椎管狭窄患者的临床资料，对比术前术后腰椎JOA和VAS评分和腰椎影像学检查结果，并对患者的满意度进行调查。结果患者无神经损伤发生，围手术期无心脑血管事件等合并症出现，2例患者发生硬膜囊撕裂，1例患者发生伤口感染，平均住院时间为5．23d。术后3个月腰椎JOA评分较术前显著提高，VAS评分较术前显著降低。术后1年患者满意度为92％，术后1年患者无腰椎失稳加重。结论显微镜下一侧入路双侧减压是治疗老年腰椎管狭窄的理想手术方式。

Objective To discuss the safety and effectiveness of the bilateral decompression under microscope via unilateral approach for the elder lumbar spinal stenosis patients. Methods The clinical materials of 24 cases of elder lumbar spinal stenosis patients admitted from Jan 2008 to Jan 2011 were reviewed. Lumbar JOA, VAS and the image results before and post operation were compared, and the degree of satisfaction 1 year after operation was investigated. Results There was no nerve injury happened, and there was no cardio -cerebral vascular events happened in the preoperative period. Dura sac was tear in 2 cases and wound infection happened in 1 case. The average stay post operation was 5.23 days. Lumbar JOA was significantly higher and VAS was significantly lower than pre - operation. The degree of satisfaction 1 year after operation was 92%, The instability of lumbar spine was not become severe 1 year post operation. Conclusion The bilateral decompression under microscope via unilateral approach is ideal operation method for the elder lumbar spinal stenosis patients