保留棘突双侧潜行扩大开窗减压术联合独活寄生汤加减治疗腰椎间盘突出合并椎管狭窄症76例临床观察

Treatments of lumbar disc herniation with spinal stenosis by combination of sneak expand bilateral fenestration decompression reserved spinous and Duhuojisheng decoction

目的观察保留棘突双侧潜行扩大开窗减压术结合中药内服治疗腰椎间盘突出合并椎管狭窄症的临床疗效。方法将151例腰椎间盘突出合并椎管狭窄症患者随机分为2组。对照组75例予保留棘突双侧潜行扩大开窗减压术治疗,治疗组76例在对照组治疗基础上加用独活寄生汤加减治疗。采用日本骨科学会腰背痛手术评分标准(JOY评分)评价术后1个月末手术疗效和并发症发生情况。结果治疗组提高JOY评分幅度、JOY改善率高于对照组(P<0.01),且住院时间短于对照组(P<0.01)。治疗组手术并发症发生率14.47%,对照组手术并发症发生率30.67%,治疗组低于对照组(P<0.05)。结论保留棘突双侧潜行扩大开窗减压术联合独活寄生汤加减治疗腰椎间盘突出合并椎管狭窄症疗效确切。

Objective To observe the effect of combination of sneak expand bilateral fenestration decom- pression reserved spinous and Duhuojisheng decoction on lumbar disc herniation with spinal stenosis. Methods 151 cases of lumbar disc herniation with spinal stenosis were randomly divided into two groups. 75 patients in control group were treated by sneak expand bilateral fenestration decompression reserved spinous. 76 cases in treatment group were treated by combination of sneak expand bilateral fenestration decompression reserved spinous and Duhuojisheng decoction. Surgery curative effect and complications were evaluated by Japanese Orthopaedic Association scoring back pain surgery（JOAS） after a month of operation. Results The rating magnitude of JOAS and JOA improvement rate in treatment group was higher than that in control group（P 〈0.01 ）. The hospital stay was shorter than that in the control group（P 〈 0.01 ）. The surgical complications incidence in treatment group（ 14.47% ）was lower than that in control group （ 30.67%, P 〈 0.05 ）. Conclusion The combination of sneak expands bilateral fenestration decompression reserved spinous and Duhuojisheng decoction has definite curative effect on lumbar disc herniation with spinal stenosis.