退化性脊椎病变前方入路手术适应证探讨

Anterior spinal surgery in degenerative lumbar spine:investigation on its indication

目的探讨退化性脊椎病变前方入路手术的适应证。方法回顾性分析１４２例接受过前方手术的病例，根据不同病情，划分出不同组别，分别讨论其预后。结果总体疗效评价优等者占８２％，一般者占１５％，不好者占３％。结论总结出４项适应证：（１）椎间盘突出症，尤其是中央型突出者以及椎间盘伴有过渡型腰骶变形者。（２）脊椎骨关节病变为主的病灶。（３）Ⅰ度脊椎前倾滑脱症者，或其合并有椎间盘病变者。（４）曾接受椎间盘手术。

Objective To probe the indication of anterior spinal surgery in degenerative lumbar spine. Method 142 cases were studied retrospectively. They were classified into 4 main groups studied and the prognosis in each group was studied. Results The evaluation of general therapeutic effect is as follows:good result accounts for 82%, average 15% and not good 3%. Conclusions 4 indications for the anterior spinal surgery: (1) HIVD, especially in the group of central type of disc lesion or disc lesion accompanied with transitional vertebra. (2) Degenerative spondyloarthropathy. (3) Slight degree of spondylolishesis with or without disc lesion. (4) Failed back surgery syndrome with impingement neuropathy by the residual disc and cause severe clinical disability.