单侧椎管小窗口减压植骨成形内固定治疗腰椎管狭窄症临床观察

Unilateral vertebral canal decompression and bone forming small window and internal fixation for the treatment of lumbar spinal canal stenosis clinical observation

目的观察单侧椎管小窗口减压植骨成形内固定治疗腰椎管狭窄症临床疗效。方法自2010年10月~2014年03月,对我院41例腰椎管狭窄症病友进行了单侧椎管小窗口减压植骨成形内固定治疗手术,其中男14例,女27例,平均年龄62岁（38~86岁）。单节段病变28例,双节段12例,三节段以上1例。结果 41例病例均获随访,随访时间9至30个月,平均19个月,采用Mann标准,恢复和部分恢复39例,未恢复2例。术前及末次随访采用日本矫形学会下腰痛评分法（JOA）、Oswestry功能障碍指数（ODF）对手术疗效评价,术前术后JOA、ODI值差异有统计学意义。结论单侧椎管小窗口减压植骨成形内固定治疗腰椎管狭窄症技术,能达到可靠的生物力学强度,可获得与双侧手术相似的临床效果,可减轻手术创伤和医疗费用负担。

Objective To observe the small window unilateral vertebral canal decompression and bone forming internal fixation treatment of lumbar spinal stenosis disease clinical curative effect. Methods From October 2014 to March 2010,41 cases of lumbar spinal stenosis patients in our hospital were unilateral vertebral canal decompression and bone forming small window internal fixation surgery treatment, among them： 14 patients with male, 27 patients with women, average age 62 years（38 to 86）. Single segment lesions in 28 cases, double festival period of 12 cases, more than three pieces in 1 case. Results 41 cases have been followed up, the follow-up time 9 to 30 months, an average of 19 months, adopt Mann standard, recovery and some recovery 39 cases, not recovered in 2 cases. Preoperatively and at the end of the follow-up sessions using Japanese orthopedic association low back pain score（JOA）, Oswestry disability index（ODI）for surgical curative effect evaluation of preoperative postoperative JOA, ODI value difference was statistically significant.Conclusion Unilateral vertebral canal decompression and bone forming small window internal fixation treatment of lumbar spinal stenosis disease technology, can achieve reliable biomechanical strength, can obtain similar to bilateral surgery clinical effect, can reduce surgical trauma and medical fee burden.