有限减压植骨融合术与椎板切除减压融合内固定术治疗老年退变性腰椎管狭窄症的效果

Effect of Limited Decompression and Bone Grafting Fusion and Laminectomy Decompression and Fusion with Internal Fixation in the Treatment of Degenerative Lumbar Spinal Stenosis in the Elderly

目的:探讨有限减压植骨融合术和椎板切除减压融合内固定术治疗老年退变性腰椎管狭窄症的效果。方法:选取2017年1月-2018年1月笔者所在科室收治的老年退变性腰椎管狭窄症患者60例,按照随机数字表法分为A、B组,各30例。A组采取有限减压植骨融合术治疗,B组采取椎板切除减压融合内固定术治疗。对两组术中出血量、手术持续时间及下肢疼痛评分(JOA)优良率进行比较。结果:A组术中出血量少于B组,手术持续时间短于B组,差异均有统计学意义(P<0.05);A组JOA评分优良率为83.33%,B组JOA评分优良率为86.67%,两组JOA评分优良率比较,差异无统计学意义(P>0.05)。结论:有限减压植骨融合术和椎板切除减压融合内固定术治疗老年退变性腰椎管狭窄症均具有良好的效果,但前者术中出血量更少,手术持续时间更短,值得临床应用。

Objective:To explore the effect of limited decompression and bone grafting fusion and laminectomy decompression and fusion with internal fixation in the treatment of degenerative lumbar spinal stenosis in the elderly.Method:A total of 60 cases of senile degenerative lumbar spinal stenosis admitted to our department from January 2017 to January 2018 were selected and divided into the group A and the group B according to the random number table method,30 cases in each group.And the group A was treated with limited decompression and bone grafting fusion,and the group B was treated with laminectomy decompression and fusion with internal fixation.The amount of intraoperative bleeding,the duration of the operation,and the excellent and good rate of lower limb pain score(JOA)were compared between the two groups.Result:The amount of intraoperative bleeding in the group A was less than that of the group B,and the duration of the operation in the group A was significantly shorter than those of the group B,and the differences were statistically significant(P<0.05).The excellent and good rate of JOA score in the group A was 83.33%,and the excellent and good rate of JOA score in the group B was 86.67%.The excellent and good rate of JOA score was compared between the two groups,and the difference was not statistically significant(P>0.05).Conclusion:Limited decompression and bone grafting fusion and laminectomy decompression and fusion with internal fixation have good results in the treatment of degenerative lumbar spinal stenosis in the elderly,but the former has less amount of intraoperative bleeding and shorter duration of the operation,which is worthy of clinical application.