| Quadrant微创通道下单侧开窗减压与开放减压内固定术治疗退变性腰椎管狭窄症病例对照研究 |
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Received:May 20, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 文天林 |
WEN Tian-lin |
北京军区总医院骨科, 北京 100700
解放军医学院, 北京 100853 |
Department of Orthopaedics, Beijing Army General Hospital, Beijing 100700, China |
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| 刘秀梅 |
LIU Xiu-mei |
北京军区总医院骨科, 北京 100700 |
Department of Orthopaedics, Beijing Army General Hospital, Beijing 100700, China |
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| 杜培 |
DU Pei |
北京军区总医院骨科, 北京 100700 |
Department of Orthopaedics, Beijing Army General Hospital, Beijing 100700, China |
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| 张天阳 |
ZHANG Tian-yang |
北京军区总医院骨科, 北京 100700 |
Department of Orthopaedics, Beijing Army General Hospital, Beijing 100700, China |
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| 王飞 |
WANG Fei |
北京军区总医院骨科, 北京 100700 |
Department of Orthopaedics, Beijing Army General Hospital, Beijing 100700, China |
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| 李放 |
LI Fang |
北京军区总医院骨科, 北京 100700 |
Department of Orthopaedics, Beijing Army General Hospital, Beijing 100700, China |
fangl6722@sina.com |
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| 期刊信息：《中国骨伤》2014年27卷，第8期，第658-662页 |
| DOI：10.3969/j.issn.1003-0034.2014.08.010 |
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目的：比较微创通道下单侧椎板开窗减压术与开放减压内固定术治疗腰椎管狭窄症的疗效。
方法：对2008年3月至2011年2月手术治疗的82例腰椎管狭窄症患者进行回顾性分析。根据手术方式不同分为A、B两组，A 组32例，采用微创通道下单侧椎板开窗椎管减压术治疗，男13例，女19例；平均年龄（56.31±4.31）岁；减压1个节段23例，2个节段9例。B组50例，采用开放减压内固定术治疗，男18例，女32例；平均年龄（57.53±4.28） 岁；减压1个节段38例，2个节段12例。术前术后均采用视觉分析量表（visual analog scale，VAS）和Oswestry功能残损量表（Oswestry disability index ，ODI），评估腰痛、腿痛和行走耐受性（行走距离和耐受程度）.
结果：82例均获随访，平均随访时间32.8个月（10.9~43.4个月），两组患者在年龄、狭窄节段、术前腰腿痛VAS和ODI方面差异无统计学意义，但A组手术时间比B组短，出血量、住院时间、恢复日常生活时间和住院费用等方面比B 组少。并发症方面两组间差异无统计学意义。
结论：微创单侧椎板开窗减压术是治疗退变性腰椎管狭窄症的微创、有效的手术方式，可以在保留后方稳定结构的前提下使神经结构得到充分减压，在手术时间、出血量、住院时 间、恢复日常生活时间和住院费用等方面有明显优势，可在把握严格手术适应证的前提下作为治疗退变性腰椎管狭窄症特别是老年患者的主要手术方法。 |
| [关键词]:腰椎 椎管狭窄 外科手术,微创性 减压 脊柱融合术 |
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| Case-control study on therapeutic effects between unilateral decompression via fenestration under Quadrant retractor and open decompression technique with fusion and internal fixation for the treatment of lumbar spinal stenosis |
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Abstract:
Objective: To compare therapeutic effects between unilateral decompression technique only and open decompression technique with fusion and internal fixation for the treatment of lumbar spinal stenosis.
Methods: From March 2008 to February 2011,82 patients with lumbar spinal stenosis were treated with operations,and divided into two groups. There were 13 males and 19 females in group A,with a mean age of (56.31±4.31) years old. The patients in group A were treated with unilateral decompression via fenestration technique only,including 23 patients obtaining single level decompression and 9 patients obtaining two levels decompression. In group B,there were 18 males and 32 females,with a mean age of (57.53±4.28) years old. The patients in group B were treated with open decompressive technique with fusion and internal fixation,including 38 patients obtaining single level decompression and 12 patients obtaining two levels decompression. The VAS of back pain and leg pain,ODI were recorded before and after surgery to evaluate low back pain,leg pain and walking tolerance.
Results: All the patients were followed up,and the duration ranged from 10.9 to 43.4 months,with a mean of 32.8 months. There were no differences in age,stenosis level,VAS of back and leg pain and ODI before surgery between two groups. Compared with the corresponding ones in group B,the operation time,blood loss,hospitalization time,recovery time of routine daily life and finacial expenditure of patients were all shorter or less in group A. There was no statistically difference in complications between two groups.
Conclusion: “Unilateral decompression via fenestration technique” is a less invasive and more effective decompressive technique for degenerative spinal stenosis without posterior elements damage. It has advantages in operation time,blood loss,hospitalization time,recovery to daily life and financial expenditure. When controlling the operative indications strictly,the technique could be an important procedure for surgical treatment of degenerative spinal stenosis,especially in the elderly population. |
| KEYWORDS:Lumbar vertebrae Spinal stenosis Surgical procedures,minimally invasive 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: | 文天林,刘秀梅,杜培,张天阳,王飞,李放.Quadrant微创通道下单侧开窗减压与开放减压内固定术治疗退变性腰椎管狭窄症病例对照研究[J].中国骨伤,2014,27(8):658~662 |
| 英文格式: | WEN Tian-lin,LIU Xiu-mei,DU Pei,ZHANG Tian-yang,WANG Fei,LI Fang.Case-control study on therapeutic effects between unilateral decompression via fenestration under Quadrant retractor and open decompression technique with fusion and internal fixation for the treatment of lumbar spinal stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(8):658~662 |
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