摘要
目的 :介绍一种椎板减压后椎板棘突复合体翻转 90°回植椎管成形术治疗腰椎管狭窄症的方法 ,评价其在治疗腰椎管狭窄症中的应用效果。方法 :对 33例腰椎管狭窄症患者采用全椎板复合体切取后 ,翻转 90°回植重建椎管后壁的方法进行治疗 ,分别于术前、术后 1年及术后 5年进行下腰痛JOA评分及影像学检查。结果 :33例患者均获得随访 ,术后 3个月复查CT示 :椎管成形术后 ,椎管扩大显著 ,大部分椎板棘突复合体已与周围骨质完全融合固定 (88% )。术后 1年时下腰痛评分较术前有显著性差异 ,术后 5年评分与术后 1年无显著性差异。结论 :椎板棘突复合体回植椎管成形术有利于脊柱稳定性的重建 ,减少硬脊膜疤痕粘连的机会 ,椎管扩大明显 ,长期疗效肯定 ,值得临床推广使用。
Objective:To introduce a method for the treatment of lumbar spinal canal stenosis with vertebral canaloplasty by removing the complex of laminae and spinous and reattaching the laminae after being reversed 90°,and to evaluate its clinical effect.Methods:33 patients with lumbar spinal canal stenosis were treated with spinal canal decompression by removing the complex of laminae and spinous and reconstructing vertebral canals by the way of reattaching the laminae after reversing the complex 90°.Preoperative and postoperative clinical results were analyzed according to JOA score and results of X-ray and CT.Results:All the patients were followed up.Reviewing at CT in the 3rd months after operation,the area of the spinal canal were significantly increased and the most of complex of laminae and spinous were fused to the laminae (88%).There were no compression of vertebral canals and nerve or dura mater.The JOA score of 1 and 5 years after operation was increased significantly than that before operation.At 1 and 5 years after operation,there was no significant differences.Conclusion:This method is beneficial to reconstrustion of spinal stability,which can decrease adherent chance of scar of spinal dura mater and obviously increase the area of the spinal canal.The long-term result is affirmative,so it is worthy of wide application.
出处
《中国骨伤》
CAS
2004年第7期400-402,共3页
China Journal of Orthopaedics and Traumatology
