摘要
目的 探讨后外侧入路减压椎间植骨融合内固定治疗胸椎管狭窄症的疗效及安全性。方法 胸椎管狭窄症患者32例,均采用后外侧入路减压椎间植骨融合内固定治疗。在术前、术后1年及术后2年行Frankel脊髓功能分级,术后2年行Otani分级疗效评定,记录手术并发症发生情况。结果 所有患者均顺利完成手术。手术时间2.3～5.2 h,平均（3.5±0.6）h;术中出血量450～2 000 m L,平均（950±100）m L。术后1年Frankel分级C、D、E级分别为17例、12例、3例,术后2年Frankel分级C、D、E级分别为8例、17例、7例,术后1年、2年与术前分别比较,差异均有统计学意义（P〈0.05）。术后1年与术后2年比较,差异均有统计学意义（P〈0.05）。术后2年疗效评价,优15例（46.88%）,良12例（37.50%）,可5例（15.62%）,优良率为84.38%。1例患者术中发生脑脊液漏,1例术后即刻出现脊髓功能障碍加重,经针对性处理后得到有效控制。结论 后外侧入路减压椎间植骨融合内固定治疗胸椎管狭窄症具有较好的疗效,安全性高。
Objective To explore the efficacy and safety of posterolateral approach decompression combined with interbody fusion and internal fixation for the treatment of thoracic spinal stenosis. Methods A total of 32 cases with thoracic spinal stenosis underwent posterolateral approach decompression combined with interbody fusion and internal fixation. Spinal cord function was evaluated according to Frankel Classification before operation, at 1 year and 2 years after operation. And the efficacy was assessed using Otani grade at 2 years after operation. The operative complications were recorded. Results The operations were successfully completed in all of the cases. The average operative duration was （3.5 ± 0.6 ） h （ range, 2.3 to 5.2 h）. The average intraoperative blood loss was （950 ±100） mL （range, 450 to 2 000 mL）. At 1 year after operation, 17 cases, 12 cases and 3 cases were assessed as grade C, D and E according to Frankel Classification respectively. At 2 years after operation, 8 cases, 17 cases and 7 cases were assessed as grade C, D and E respectively. There were statistical differences in the grades at 1 year and at 2 years after operation compared with the grade before operation （ P 〈 0.05 ）. And a statistical difference in the Frankel grade was observed between 1 year and 2 year after operation （P 〈 0. 05）. The evaluation of clinical efficacy at 2 years after operation showed that 15 cases （46.88%） were excellent, 12 cases （37.50%） were good and 5 cases were common （ 15.62% ） . The excellent and good rate was 84.38%. Cerebrospinal fluid leakage occurred in one case during operation, and the spinal cord dysfunction of one case was aggravated postoperatively, but the situation was under control effectively after the targeted management. Conclusions Posterolateral approach decompression combined with interbody fusion and internal fixation is effective and safe for patients with thoracic spinal stenosis.
出处
《微创医学》
2015年第4期429-431,共3页
Journal of Minimally Invasive Medicine
