节段性潜行减压治疗腰椎管狭窄症

Segmental Undercutting Decompression in the Treatment of Lumbar Spinal Stenosis

目的 :探讨中央型腰椎管狭窄的手术方式 ,讨论采用节段性潜行减压这一术式的可行性。方法 :对 3 5例病人 ,根据术前X线、CT、椎管造影等检查 ,针对性地对一个或两个或多个节段进行潜行减压 ,对伴有侧隐窝狭窄者同时给予扩大成形。结果 :3 2例病人获随访 ,随访时间 6～ 48个月 ,平均 3 0个月 ,优良率 93 .75 %。结论 :节段性潜行减压术治疗中央型腰椎管狭窄症 ,通过有限的椎板及关节突切除 ,能够潜行扩大椎管狭窄的中央部及侧隐窝 ,并能摘除增厚的黄韧带和退变的椎间盘 ,较好地保留了腰椎的后部结构 ,既能解除对马尾和神经根的压迫 ,又能保持后柱的稳定性。该方法对于后柱的稳定性优于传统的椎板切除术。

Objective:To explore the segmental undercutting decompression technique in the treatment of lumbar spinal stenosis.Methods:Of 35 patients who underwent segmental undercutting decompression surgery for treatment of typical lumbar spinal stenosis between 1997 and 2000.The mean age at surgery were 52 years.Results:32 patients post operation following up ranged from 6 months to 48 months,the average follow up were 30 months,93.75 percent have the excellent or good results.Conclusions:This technique is easily undercutting in laminoplasty and facetectomy,and allows excellent canal visualization for complete removal of the thickening ligamentum flavum and the degenerative intervertebral disks,and decompression with minimal bone resection to preserve stability of posterior column of spine.