单侧椎板开窗减压联合椎弓根螺钉内固定融合治疗腰椎管狭窄症40例疗效观察

Observation on efficacy of unilateral laminectomy for decompression combined with pedicle screw internal fixation and fusion for the treatment of 40 cases of lumbar spinal stenosis

目的 探讨单侧椎板开窗减压联合椎弓根螺钉内固定融合治疗腰椎管狭窄症的临床效果.方法 40例腰椎管狭窄症患者,均采用单侧椎板开窗减压联合椎弓根螺钉内固定融合治疗,观察治疗效果,比较术前、术后视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI),观察、术后随访情况.结果 患者术后无并发症发生.患者术前VAS评分、ODI评分分别为(6.09±1.60)分、(60.53±6.29)%,术后3个月分别为(2.30±0.52)分、(26.38±6.60)%,术后6个月分别为(1.09±0.60)分、(13.21±4.39)%、术后12个月分别为(0.83±0.26)分、(10.20±5.52)%,患者术后VAS评分、ODI均明显低于术前,术后3、6、12个月VAS评分、ODI依次降低,两两比较差异均具有统计学意义(P<0.05).患者术后治疗效果优良率为90.0%(36/40).结论 单侧椎板开窗减压联合椎弓根螺钉内固定融合治疗腰椎管狭窄症,有效改善了神经功能,值得采用.

Objective To discuss the clinical efficacy of unilateral laminectomy for decompression combined with pedicle screw internal fixation and fusion for the treatment of lumbar spinal stenosis.Methods A total of 40 patients with lumbar spinal stenosis all treated by unilateral laminectomy for decompression combined with pedicle screw internal fixation and fusion.The therapeutic effect was observed.The visual analogue scale(VAS)score and Oswestry disability index(ODI)scores before and after operation was compred,and the situation of postoperative follow-up were observed.Results No complications occurred after operation.The VAS score and ODI were(6.09±1.60)points and(60.53±6.29)%respectively before operation,(2.30±0.52)points and(26.38±6.60)%at 3 months after operation,(1.09±0.60)points and(13.21±4.39)%at 6 months after operation,(0.83±0.26)points and(10.20±5.52)%at 12 months after operation.The VAS score and ODI after operation was obviously lower than those before operation,and the VAS score and ODI decreased successively at 3,6 and 12 months after operation,and the difference was statistically significant in pairwise comparison(P<0.05).The excellent-good rate of postoperative treatment was 90.0%(36/40).Conclusion Unilateral laminectomy for decompression combined with pedicle screw internal fixation and fusion for the treatment of lumbar spinal stenosis can effectively improve the nerve function,and it is worthy of application.