天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (3): 268-270.doi: 10.11958/20150170

• 专题研究-骨疾病 • 上一篇    下一篇

后路腰椎全椎板减压术后腰椎失稳对预后的影响

刘钢 李爽， 邓树才， 郝永宏， 荆峰   

  1. 天津市天津医院脊柱外科
  • 收稿日期:2015-09-15 修回日期:2015-12-31 出版日期:2016-03-15 发布日期:2016-03-15
  • 通讯作者: 邓树才 E-mail:34383418@qq.com
  • 作者简介:刘钢（1981）， 男， 主治医师， 硕士， 主要从事脊柱外科研究
  • 基金资助:
    天津市卫生局科技基金资助项目

Long term follow up of the spinal stenosis and symptoms after lamina decompression

LIU Gang, LI Shuang, DENG Shucai，HAO Yonghong, JING Feng   

  1. Department of Spine, Tianjin Hospital, Tianjin 300211, China
  • Received:2015-09-15 Revised:2015-12-31 Published:2016-03-15 Online:2016-03-15
  • Contact: DENG Shucai E-mail:34383418@qq.com

PDF (PC)

3874

摘要： 【摘要】目的 通过对后路全椎板减压术后患者进行随访，研究术后腰椎失稳与腰椎预后的关系。方法 回顾1990年1月1日至2014年12月31日期间的全椎板减压患者共132例进行随访，其中76例患者获得4年以上随访。通过末次随访的影像学资料将患者分为失稳组以及无失稳组，比较两组术前、术后1个月以及末次随访的VAS评分、JOA评分以及术后JOA改善率等指标，采用t检验及χ2检验方法对所得数据进行统计学分析，以P＜0.05认为差异存在统计学意义。结果 76例手术患者中，共出现腰椎失稳患者27例，未出现腰椎失稳患者49例，分别占病例总数的35.5％和64.5%。经t检验，术前及术后患者VAS评分、JOA评分差异具有统计学意义（P＜0.05）；失稳组与非失稳组上述指标无统计学差异（P＞0.05）；末次随访时，失稳组与非失稳组无统计学差异（P＞0.05）。经χ2检验，非失稳组中改善率稍高于失稳组，但差异无明显统计学意义（P＞0.05）。结论 全椎板减压术作为一种非融合方式，其术后症状改善与否与是否存在失稳无明显关系。在严格掌握手术适应证的前提下，不失为一种更好的选择。

关键词: 【关键词】腰椎管狭窄症, 全椎板减压术, 腰椎失稳

Abstract: Abstract: Objective: To study the relationship between the spinal instability and symptoms after lamina decompression. Method: Of 132 patients who accepted lamina decompression from 1990 through 2014, 76 were followed up for a minimum of 4 years. The patients were divided into instability group and non-instability group according to the X-ray result of the last following up. Compare with the VAS score, JOA score between the two group of the preoperation, 1 month after operation and the last follow up, and the JOA improvement rate index before and after the surgery, t test and chi square test method was used to analyze the outcome, with P < 0.05 a statistically significant difference. Results: Of the 76 patients, there were 27 patients in the instability group and 49 patients in the non-instability group which accounting for 35.5% and 64.5%. There were statistical significant in the VAS and JOA score between before and after surgery (P<0.05), but there were no statistical significant in the two groups(P >0.05). In the JOA improvement rate index, the non-instability group is higher than the instability group ,but no statistical significant(P>0.05). Conclusion: As a non-fusion method, there is no relationship between instability and symptoms improvement, which would be a better choice under the premise of surgical indications.

Key words: Key words: Lumbar spinal stenosis, lamina decompression, lumbar instability