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显微镜下微创减压治疗下腰退变性椎管狭窄症
Hits: 2171   Download times: 1319   Received:July 28, 2009    
作者Author单位UnitE-Mail
陈新 CHEN Xin 南通瑞慈医院骨科,江苏 南通 226010 Department of Orthopaedics,Ruici Hospital of Nantong,Nantong 226010,Jiangsu,China xinchen_hi@126.com 
葛许峰 GE Xu-feng 南通瑞慈医院骨科,江苏 南通 226010 Department of Orthopaedics,Ruici Hospital of Nantong,Nantong 226010,Jiangsu,China  
严亮 YAN Liang 南通瑞慈医院骨科,江苏 南通 226010 Department of Orthopaedics,Ruici Hospital of Nantong,Nantong 226010,Jiangsu,China  
期刊信息:《中国骨伤》2009年22卷,第10期,第757-758页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:观察显微镜下微创减压治疗下腰退变性椎管狭窄症的临床疗效。

方法:自2007年5月至2008年11月,显微镜下微创减压治疗下腰椎管狭窄症26例,男9例,女17例;年龄47~75岁,平均53.7岁;病程2~8年,平均3.6年;单侧症状20例,双侧6例。手术前后应用JOA法评价疗效并计算改善率。

结果:单节段手术时间60~90 min,平均75 min,出血50~120 ml,平均85 ml;双节段手术时间80~180 min,平均95 min,出血60~150 ml,平均100 ml.26例均获得随访,时间6~24个月,平均8.6个月。按JOA评分法,优18例,良7例,差1例,优良率96%,平均改善率86%.术前评分3.92±0.83,术后12.67±1.92,差异有统计学意义(P<0.01).

结论:显微镜下微创减压手术治疗下腰退变性椎管狭窄症手术时间短、创伤小、操作精细、恢复快,同时可以获得良好疗效,但不适用于椎体后缘明显骨化或钙化、椎管内粘连较重的患者。
[关键词]:腰椎  椎管狭窄  外科手术,微创性  显微镜检查  减压
 
Microscope-assisted minimally invasive decompression for degenerative lower lumbar spinal stenosis
Abstract:

Objective: To evaluate clinical results of microscope-assisted minimally invasive decompression for degenerative lower lumbar spinal stenosis.

Methods: From May 2007 to November 2008,26 patients with degenerative lower lumbar spinal stenosis were treated with microscope-assisted minimally invasive decompression. Including 9 males and 17 females,the mean age were 53.7 years(range in 47-75 years). The course of disease was from 2 to 8 years with an average of 3.6 years. Single segment symptom had 20 cases and double segments had 6 cases. The clinical effects were evaluated and improvement rate was calculated according to JOA scoring before and after operation.

Results: The operative time in single segment was 60-90 minutes with an average of 75 minutes and in double segments was 80-180 minutes with an average of 95 minutes. The operative bleeding in single segment was 50-120 ml with an average of 85 ml and in double segments was 60-150 ml with an average of 100 ml. All the patients were followed up with an average of 8.6 months(range in 6-24 months). The clinical effects were evaluated according to JOA scoring,excellent in 18 cases,good in 7,poor in 1,the rate of excellent and good was 96% and improvement rate was 86%. The mean JOA scoring was respectively 3.92±0.83 and 12.67±1.92 before and after operation. There was significantly statistic difference between before and after operation(P<0.01).

Conclusion: Microscope-assisted minimally invasive decompression for degenerative lower lumbar spinal stenosis can obtain satisfactory therapeutic effect,which had advantages of short operative time,less trauma,subtle operation,fast restoration,but it is inapplicable for the patients with obviously ossification or calcification of vertebral body,severe vertebral canal adherence.
KEYWORDS:Lumbar spine  Spinal stenosis  Surgical procedures,minimally invasive  Microscope  Decompression
 
引用本文,请按以下格式著录参考文献:
中文格式:陈新,葛许峰,严亮.显微镜下微创减压治疗下腰退变性椎管狭窄症[J].中国骨伤,2009,22(10):757~758
英文格式:CHEN Xin,GE Xu-feng,YAN Liang.Microscope-assisted minimally invasive decompression for degenerative lower lumbar spinal stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(10):757~758
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