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(1)
【摘要】 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)%， 患者術后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。
【关键词】 腰椎管狭窄症;单侧椎板开窗减压;椎弓根螺钉内固定术
DOI：10.14163/j.cnki.11-5547/r.2019.30.013
【Abstract】 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.
【Key words】 Lumbar spinal stenosis; Unilateral laminectomy for decompression; Pedicle screw internal fixation
作为临床常见病， 腰椎管狭窄症是指各种形式椎管、椎间孔及神经管狭窄的总称， 病理机制分为四种情况， 即神经根嵌压、神经体液运转障碍、刺激神经末梢、静脉回流受阻， 会引发腰腿疼痛， 进而出现行动障碍[1， 2]。本研究分析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疗效。现报告如下。
1 资料与方法
1. 1 一般资料 随机抽选出2008年1月～2017年12月本院收治的腰椎管狭窄症患者40例作为研究对象， 患者均通过症状观察、体征检查及影像学检查确诊为腰椎管狭窄症， 均签署了知情同意书， 经本院医学伦理委员会批准， 排除了合并心肝肾功能不全、恶性肿瘤、精神或意识障碍患者。其中男21例， 女19例;年龄42～65岁， 平均年龄(53.5±3.9)岁;退行性病变29例， 先天性发育异常11例。2例合并腰椎轻度滑脱， 8例合并高血压， 3例合并糖尿病。, http://www.100md.com(翁阳华 张洪亮 陈贵彬 李忠辉)
【关键词】 腰椎管狭窄症;单侧椎板开窗减压;椎弓根螺钉内固定术
DOI：10.14163/j.cnki.11-5547/r.2019.30.013
【Abstract】 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.
【Key words】 Lumbar spinal stenosis; Unilateral laminectomy for decompression; Pedicle screw internal fixation
作为临床常见病， 腰椎管狭窄症是指各种形式椎管、椎间孔及神经管狭窄的总称， 病理机制分为四种情况， 即神经根嵌压、神经体液运转障碍、刺激神经末梢、静脉回流受阻， 会引发腰腿疼痛， 进而出现行动障碍[1， 2]。本研究分析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疗效。现报告如下。
1 资料与方法
1. 1 一般资料 随机抽选出2008年1月～2017年12月本院收治的腰椎管狭窄症患者40例作为研究对象， 患者均通过症状观察、体征检查及影像学检查确诊为腰椎管狭窄症， 均签署了知情同意书， 经本院医学伦理委员会批准， 排除了合并心肝肾功能不全、恶性肿瘤、精神或意识障碍患者。其中男21例， 女19例;年龄42～65岁， 平均年龄(53.5±3.9)岁;退行性病变29例， 先天性发育异常11例。2例合并腰椎轻度滑脱， 8例合并高血压， 3例合并糖尿病。, http://www.100md.com(翁阳华 张洪亮 陈贵彬 李忠辉)