单纯减压与减压融合内固定术治疗伴Ⅰ度退行性滑脱的腰椎管狭窄症的疗效比较探讨

Comparison and investigation of curative effects between simple decompression and decompression combined with internal fixation in the treatment of lumbar spinal stenosis complicated with degree Ⅰ degenerative spondylolisthesis

目的比较研究单纯减压和减压融合内固定术治疗伴Ⅰ度退行性滑脱的腰椎管狭窄症的疗效。方法选取30例行单纯减压术的伴Ⅰ度退行性滑脱的腰椎管狭窄症患者作为减压组,选取同期30例行减压融合内固定术治疗的伴Ⅰ度退行性滑脱的腰椎管狭窄症患者作为融合组,对比分析两组治疗的疗效。结果减压组治疗后手术时间、术中出血量等明显优于融合组,差异有统计学意义(P<0.05);两组优良率比较差异无统计学意义(P>0.05);但1年后,融合组视觉模拟评分(VAS评分)改善程度与减压组比较差异有统计学意义(P<0.05)。结论采用单纯减压和减压融合内固定术治疗伴Ⅰ度退行性滑脱的腰椎管狭窄症的疗效相当,但减压融合内固定术的远期效果更佳。

Objective To comparatively research the curative effects between simple decompression and decompression combined with internal fixation in the treatment of lumbar spinal stenosis complicated with degree Ⅰ degenerative spondylolisthesis.Methods A total of 30 patients receiving simple decompression for lumbar spinal stenosis complicated with degree Ⅰ degenerative spondylolisthesis were selected as decompression group. Another 30 patients receiving decompression combined with internal fixation were taken as the combined group. Curative effects were analyzed between the two groups.Results The decompression group had better operation time and intraoperative bleeding volume than the combined group, and the difference had statistical significance （P〈0.05）. The difference of good rates between the two groups had no statistical significance （P〉0.05）. After 1 year, the combined group had statistically significant difference of visual analogue scale（VAS） score from the combined group （P〈0.05）.Conclusion Implement of simple decompression has similar effect as decompression combined with internal fixation in treating lumbar spinal stenosis complicated with degree Ⅰ degenerative spondylolisthesis, however decompression combined with internal fixation provides better long-term effect.