后路减压联合棘突间动态稳定系统治疗退行性椎管狭窄的可行性及安全性分析

Analysis on the feasibility and safety of posterior decompression combined with interspinous dynamic stabilization system in the treatment of degenerative lumbar spinal stenosis

目的探讨后路减压联合棘突间动态稳定系统治疗退行性椎管狭窄的可行性及安全性。方法选取2008年5月至2011年12月于本院采用后路椎管环形减压术进行治疗的26例退行性椎管狭窄患者为对照组,同期采用后路减压联合棘突间动态稳定系统进行治疗的26例患者为观察组,将两组患者的治疗优良率、并发症发生率及手术前后不同时间段的疼痛程度、椎管测量参数进行比较。结果观察组的治疗优良率为96.15%,高于对照组;并发症发生率为3.85%,低于对照组,术后不同时间段的VAS评分分别为(4.0±0.7)分、(1.8±0.4)分及(1.2±0.2)分,均低于对照组;术后1个月及3个月的椎间隙前缘高度为(16.87±1.82)mm和(16.59±1.77)mm,椎间隙后缘高度为(10.93±1.71)mm和(10.46±1.64)mm,椎管面积为(157.14±16.23)mm2和(155.58±16.11)mm2,椎管矢状径为(13.62±1.59)mm和(13.54±1.56)mm,硬膜囊面积为(110.47±13.56)mm2和(109.59±13.24)mm2,其均优于对照组,差异有统计学意义(P<0.05)。结论后路减压联合棘突间动态稳定系统治疗退行性椎管狭窄的疗效和安全性均较佳。

Objective To study the feasibility and safety of posterior decompression combined with interspinous dynamic stabilization system in the treatment of degenerative lumbar spinal stenosis.Methods Twenty-six patients with degenerative lumbar spinal stenosis who were treated with annular decompression of vertebral canal in our hospital from May 2008 to December 2011 were selected as the control group,and 26 patients who were treated with posterior decompression combined with interspinous dynamic stabilization system at the same time were selected as the observation group.Then the excellent and good rate of the treatment,incidence of complications,pain degree and parameters of spinal canal before and after the treatment at different times were compared between the two groups.Results The excellent and good rate of the treatment of the observation group was 96.15%,significantly higher than that of the control group.The incidence of complications was 3.85% in the observation group,significantly lower than that of the control group.VAS score after the treatment at different times were（4.0±0.7）,（1.8±0.4） and（1.2±0.2）,significantly lower than those of the control group.Th eintervertebral space height of the front were（16.87±1.82） mm and（16.59±1.77） mm,height of the posterior intervertebral disc were（10.93±1.71） mm and（10.46±1.64） mm,spinal canal area were（157.14±16.23） mm2 and（155.58±16.11） mm2,sagittal diameter of vertebral canal were（13.62±1.59） mm and（13.54±1.56） mm,dural sac area were（110.47±13.56） mm2 and（109.59±13.24） mm2,which were all significantly better than those of the control group,P0.05.Conclusion The feasibility and safety of posterior decompression combined with interspinous dynamic stabilization system is better in the treatment of degenerative lumbar spinal stenosis.