老年多节段腰椎间盘突出症合并椎管狭窄的外科治疗

摘要

目的 探讨老年多节段腰椎间盘突出症合并椎管狭窄外科治疗的临床疗效.方法 对21例老年多节段腰椎间盘突出症合并椎管狭窄患者采用椎板减压、髓核摘除、椎体间融合同时椎弓根内固定治疗.对患者术前、术后及末次随访时进行视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评估,采用Macnab标准进行临床疗效评定.结果 21例均获随访,时间13~46个月.术后及末次随访时VAS评分和ODI评定与术前比较差异均有统计学意义(P<0.01).疗效评价:优9例,良9例,可3例.结论 后路减压、髓核摘除、椎体间融合同时椎弓根内固定治疗老年多节段腰椎间盘突出症合并椎管狭窄安全有效.%Objective To investigate the effects of surgery for multi-segmental lumbar disc herniation in elderly patients with spinal stenosis. Methods 21 elderly patients diagnosed with multi-segmental lumbar disc herniation with spinal stenosis, underwent laminectomy, discectomy, and posterior lumbar interbody fusion with pedicle screw fixation technique. The visual analog scale ( VAS ), Oswestry disability index ( ODI ) and Macnab standards were used to evaluate the clinical effectiveness. Results All cases were followed up for 13 ~46 months. The VAS and ODI scores were significantly improved after surgery and at ultimate follow up compared with those before surgery ( P < 0. 01 ). The results were excellent in 9 cases, good in 9 and fair in 3. Conclusions Laminectomy, discectomy, and posterior lumbar interbody fusion with pedicle screw fixation is a safe and effective treatment of lumbar disc herniation in elderly patients with spinal stenosis.