| 腰椎管狭窄的治疗进展 |
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投稿时间：2017-02-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 史少岩 |
SHI Shao-yan |
西安医学院, 陕西 西安 710068
西安交通大学附属红会医院, 陕西 西安 710054 |
The Red Cross Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 黄研生 |
HUANG Yan-sheng |
西安医学院, 陕西 西安 710068 |
The Red Cross Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shaanxi, China |
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| 郝定均 |
HAO Ding-jun |
西安交通大学附属红会医院, 陕西 西安 710054 |
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haodingjun@123.com |
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| 期刊信息：《中国骨伤》2017年，第30卷，第5期，第484-488页 |
| DOI：10.3969/j.issn.1003-0034.2017.05.006 |
| 基金项目: |
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| 中文摘要:随着我国人口老龄化加剧，以退行性改变为主的腰椎管狭窄症患者不断增多。腰椎管狭窄目前没有足够的证据推荐任何特定类型的非手术治疗，手术是治疗腰椎管狭窄的有效方法，腰椎管狭窄患者不经过保守治疗而采用手术改善临床症状具有最强的证据基础。单纯减压术后脊柱节段不稳促使融合技术的发展，融合后相邻节段退变加速、症状不缓解导致动态固定技术应运而生。患者在行椎管减压的同时是否需植骨融合至今仍存在较大争议，近年来我国治疗腰椎管狭窄的单纯减压手术明显下降，然而减压加融合手术却持续增加。椎管减压同时辅以腰椎融合，越来越多被应用于腰椎管狭窄来减少脊柱不稳和畸形的潜在风险。虽然减压手术治疗是有一定的临床效果，但目前尚不清楚是否减压附加融合手术的结果要优于单纯减压手术。本文对腰椎管狭窄患者是否需要融合进行综述研究，旨在进一步探讨腰椎管狭窄手术治疗的最佳选择，专注于以证据为基础的治疗方案。 |
| 【关键词】椎管狭窄 减压 脊柱融合术 |
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| Therapeutic progress in lumbar spinal stenosis |
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| ABSTRACT Along with the population aging in China,patients with lumbar spinal stenosis(LSS) caused by recessive change incessantly increase. At present,there is no adequate evidence to recommend any specific nonoperative treatment for LSS,and surgery is still an effective method. The cilincal symptoms of the patients without conservative treatment got improvement after surgery,which is the strongest evidence base. Spinal instability after simple decompression promotes the development of fusion technique,and the accelerated adjacent segment degeneration and no relief in symptoms after fusion lead to dynamic fixation technology emerge as the times require. Patients with spinal canal decompression whether need bone fusion or not is still controversial. For the past few years,the operation of simple decompression for LSS obviously decreased,whereas the decompression plus fusion surgery showed sustainable growth. Decompression complicated with fusion was more and more adopted in LSS,in order to reduce the hidden risk of spinal instability and deformity. Although decompressive operation has determinate effect,now it is still unclear if the therapeutic effect of decompression complicated with fusion is better than simple decompression. This article reviews the current studies to explore whether decompression plus bone fusion is applicable for LSS. To further explore the best choice of surgical treatment for LSS,we focused on evidence-based therapeutic options. |
| KEY WORDS Spinal stenosis Decompression Spinal fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 史少岩,黄研生,郝定均.腰椎管狭窄的治疗进展[J].中国骨伤,2017,30(5):484~488 |
| 英文格式: | SHI Shao-yan,HUANG Yan-sheng,HAO Ding-jun.Therapeutic progress in lumbar spinal stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(5):484~488 |
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