动态脊髓造影在有限减压治疗腰椎管疾病的应用

摘要

Objective To analyze the clinical significance of dynamic myelography(DM) used in limited decompression for lumbo-vertebral canal lesions (LVCL). Methods 150 patients with LVCL were orded to perform DM. According to the clinical findings,signs and the outcomes of myelog-raphy,57 cases were treated by limited decompression,68 cases were treated by conventional surgery. Results All results of DM were testified by surgery. All patients were followed up for 9-48 months with an average of 28 months. Both groups had significant differences after opera-tion(P<0.01). The improve rate of JOA score at final follow-up for each group was 62.4%±33.8%, 63.5%±27.6% respectively,with excellent and good rate was 89.4% and 86.8% in each group.The difference was not statistically siginificant between the two groups (P>0.05). Conclustion Limited decompression is reliable for LVCL,which can avoid the blindness of operation,unnecessary surgical trauma and the risk of surgery in old patients coexistence of multi diseases. DM was benefical to the treatment of LVCL by limited decompression.%目的：探讨动态脊髓造影指导有限减压治疗腰椎管疾病的意义。方法对150例腰椎管疾病患者行动态脊髓造影检查，结合患者症状、体征及造影检查结果选择不同手术方法，其中57例术中应用有限减压，68例非有限常规手术。结果两组患者术中均证实椎管造影表现。所有手术患者获得9～48个月的随访，平均28个月。末次随访JOA评分，计算改善率，两组与术前比较均有显著性差异（P<0.01），有限减压组62.4%±33.8%，常规组63.5%±27.6%，优良率分别为89.4%、86.8%，组间对比无明显统计学差异（P>0.05）。结论有限减压是治疗腰椎管疾病的一种可靠术式，可以避免手术的盲目性、不必要的手术创伤及一体多病的老年患者手术风险等。通过动态脊髓造影检查利于运用有限减压手术治疗腰椎管疾病。