Objective To explore the clinical effect of microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis and analyze the influence factors that related to clinical effect .Methods 64 old patients with multilevel lumber spinal stenosis were selected and divided into microendoscopic group and open group based on different operation method ,each group contained 32 patients .Comparison was made between two groups in respects of operation time ,amount of bleed-ing ,hospital time post-operation and Nakai scores .Analyzed the influence factors that related to clinical effect .Results The opera-tion time ,amount of bleeding ,hospital time post-operation in microendoscopic group were lower than open group ,the differences had statistical significance .Based on the Nakei score ,the curative effect in microendoscopic group was slightly lower than open group ,but the differences had no statistical significance .The JOA score pre-operation ,walking distances and complication were rela-tive factors that could influence the clinical effect of microendoscopic discectomy through posterior approach method .Conclusion Microendoscopic discectomy through posterior approach in old patients with multilevel lumber spinal stenosis had quicker postoper-ative recovery than conventional operation ,and the JOA score pre-operation ,walking distances and complication were relative fac-tors that could influence the clinical effect of microendoscopic discectomy through posterior approach method .%目的：研究后路椎间盘镜下有限减压在老年腰椎管狭窄症（LSS ）患者中的治疗应用，并探讨影响疗效的相关因素。方法选择该院收治的老年腰椎管狭窄症患者共64例，按照治疗方式不同分为椎间盘镜组及开放手术组，每组32例，对比两组患者手术时间、出血量、术后住院时间及Nakai评分，探讨影响后路椎间盘镜手术疗效的相关因素。结果两组患者手术相关指标对比显示，椎间盘镜组患者手术时间、出血量及术后住院时间均显著低于开放手术组，差异有统计学意义（P＜0．05）。Nakei疗效评估对比，椎间盘镜组术后优良率为81．3％，略低于开放手术组84．4％，差异无统计学差异（ P＞0．05）。影响后路椎间盘镜手术疗效因素显示，术前JO A评分、步行距离以及并发症为影响手术疗效的相关因素。结论后路椎间盘镜下有限减压治疗老年腰椎管狭窄症患者较常规开放手术更具有优越性，术前JOA评分、步行距离以及并发症为影响后路椎间盘镜手术疗效的相关因素，患者手术时需多加注意。
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