不同手术方案在单侧症状为主腰椎管狭窄患者中的应用效果

Comparison of different surgical procedures in patients with unilateral symptomatic lumbar spinal stenosis

[目的]探讨不同手术方案在单侧症状为主的腰椎管狭窄患者中的应用效果。[方法]回顾性分析以单侧症状为主的腰椎管狭窄症患者共86例,分为两组。甲组使用改良术式治疗,乙组使用全椎板切除术进行治疗。比较患者的视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)、日本骨科协会评分(JOA)、手术时间和术中出血量。[结果]在手术前,两组患者的VAS、ODI、JOA无差异(P>0.05),术后3、6、12 mon患者的VAS、ODI、JOA与术前相比,结果有统计学意义(P<0.05),术后12 mon与乙组相比有差异(P<0.05);甲组患者的术中出血量、手术时间均少于乙组(P<0.05)。[结论]使用单侧椎板入路双侧减压的椎间隙植骨融合内固定术能够很好地改善单侧症状为主的腰椎管狭窄患者的症状,且手术时间短,术中出血量少,具有良好的稳定性,值得在临床上推广。

[Objective]To investigate the effect of different surgical procedures on patients with lumbar spinal stenosis with unilateral symptoms.[Methods]86 cases of patients with lumbar canal stenosis with unilateral symptoms were analysised retrospectively.The patients were divided into two groups.The group A was used modified surgical treatment;group B patients were treated with laminectomy.The visual analogue scale(VAS),Oswestry disability index(ODI),Japanese Orthopaedic Association Scores(JOA),operative time and the bleeding volum were compared.[Results]Before surgery,there is no difference between the two groups of patients with VAS,ODI and JOA(P>0.05),twelfth months after surgery in patients with VAS,ODI and JOA compared with the preoperative results were statistically significant(P<0.05);compared with group B,the bleeding volume and operation time was less than in group A(P<0.05).[Conclusion]The use of lumbar unilateral approach for bilateral decompression of the lumbar interbody fusion can effectively improve the symptoms of unilateral stenosis patients,and the operative time is short,bleeding volum is less,and it has good stability,it is worth popularizing in clinical use.