摘要
目的 临床及影像学评估保留腰椎后部复合结构经椎板间减压治疗腰椎管狭窄症的疗效。方法 显露一侧椎板后经棘突截骨,将棘突一韧带一骶棘肌推离对侧椎板,切除椎板间黄韧带,潜行扩大中央椎管,切除椎体后缘骨赘及突出的椎间盘,凿除部分内聚的关节突,使中央椎管及神经根管管径扩大。此术式治疗腰椎管狭窄症63例,其中伴椎体假性滑脱者9例,术前诊断有腰椎不稳者3例,同时行椎弓根系统固定、后外侧植骨。随访2～7年,参照日本骨科学会15分法,对功能和疗效进行评定。结果 63例由术前得分平均2.9分增至术后得分平均13.7分,平均改善10.8分,改善率88.7％。优良率100％。CT显示术后椎管中矢径、横径明显增大,棘突截骨均达骨愈合。结论 保缺腰椎后部复合结构经椎板间减压术使腰椎稳定性的破坏减至最小,椎管减压充分,术后组织愈合好,并发症少,是治疗腰椎管狭窄症较满意的术式。
Objective To evaluation the result of internal vertebral lamina depression preserving posterior lum-
bar complex to treatment the lumbar vertebral canal stenosis by using the methods of clinical scale and the radiology.
Methods The operation exposure one lateral lamina arcus vertebra and osteotomy, striping the processus spinosus liga-
ment-sacrospinalis from contralateral lamina and cutting the flavum ligament, expanding the canal latently; cutting osteo-
phyma at the back of vertebra, bulging disk and internal articulations to make the diameter of vertebra and intervertebra
foremen enlarge. Sixty-three patients received the operation and following-up study 2-7 years, nine of them complicating
with vertebra pseudodislocation, three of them with vertebra unsteady. Clinical evaluation using the 15 grade standard of
Japanese Orthopedic Association. Results The patien's average scale were 2.9 in pre-operation and 13.7 in post-opera-
tion increasing 10. 8 averagely, the rate of increasing was 88.7%, the rate of fine was 100%. CT showed the diameter of
vertebra canal enlargement post-operative, the osteotomy healing satisfying. Conclusions The operation of Internal verte-
bral laminae depression preserving the posterior lumbar complex depression sufficient while decreasing the destroy to the
lumbar vertebra dramatically, the tissue healing well, and the complications rare. The operation was ideal method to treat-
ment the lumbar vertebral canal stenosis.
出处
《中国骨肿瘤骨病》
2003年第5期294-297,共4页
Chinse Journal Of Bone Tumor And Bone Disease
