不同手术方法治疗老年退变性腰椎滑脱合并腰椎管狭窄症的临床对比分析

Clinical contrast analysis of different operation methods in the treatment of senile degenerative lumbar spondylolisthesis with lumbar spinal canal stenosis

目的探讨不同手术方法治疗老年退变性腰椎滑脱合并腰椎管狭窄症的临床疗效。方法选取本院2010年1月～2012年8月收治的老年退变性腰椎滑脱合并腰椎管狭窄症患者34例,根据手术方法将其分为两组,16例患者采用经后路椎间融合术治疗(对照组),18例患者采用改良的经椎间孔椎间融合术治疗(观察组),比较两组患者各项临床指征及临床疗效。结果观察组手术时间、术中出血量均小于对照组,差异均无统计学意义(P>0.05)。观察组Prolo腰椎功能评分明显高于对照组,观察组VAS疼痛评分、滑脱率均明显低于对照组,观察组优良率(94.4%)明显高于对照组(62.5%),差异均有统计学意义(P<0.05)。结论改良的经椎间孔椎间融合术治疗老年退变性腰椎滑脱合并腰椎管狭窄症临床疗效显著,可明显改善患者的临床指征,创伤较小且固定牢靠,滑脱率低,优良率高,值得临床推广使用。

Objective To investigate the clinical curative effect of different operation methods in the treatment of senile degenerative lumbar spondylolisthesis with lumbar spinal canal stenosis.Methods Thirty four patients of senile degenerative lumbar spondylolisthesis with lumbar spinal canal stenosis were selected in our hospital from January 2010 to August 2012.According to the operation method,patients were divided into two groups.16 patients were given posterior lumbar interbody fusion in the treatment（control group）.18 patients were given modified percutaneous interbody fusion in the treatment（observation group）.Various clinical indications and clinical curative effect were compared between the two groups.Results Operation time,bleeding volume in operation in observation group were less than that of control group,while the difference was not statistically significant（P 〈0.05）.Prolo lumbar function score in the observation group was significantly higher than the control group.VAS pain score,slippage rate in the observation group were significantly lower than that of control group.The rate of excellent in observation group（94.4%） was significantly higher than that of control group（62.5%）,the difference was statistically significant（P 〈0.05）.Conclusion Modified transforaminal lumbar interbody fusion in the treatment for senile degenerative lumbar spondylolisthesis with lumbar spinal canal stenosis has significant clinical effect,which can obviously improve the patient＇s clinical indications.That has small trauma and reliable fixation,slip rate is low,while excellent rate is high,so it is worthy of clinical use.