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[多节段腰椎间盘突出症与腰椎管狭窄症的治疗]

[Treatment of multi-segmental lumbar disc herniation and spinal canal stenosis].

作者信息

Xiao Rongchi, Li Qiang, Tang Zhihong, Zou Guoyao

机构信息

Department of Orthopedics, Affiliated Hospital of Guilin Medical College, Guilin Guangxi, 541001, P.R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Apr;22(4):404-7.

PMID:18575437
Abstract

OBJECTIVE

To explore the treatment of multi-segmental lumbar disc herniation and spinal canal stenosis by laminectomy, removal of nucleus pulposus, fusion of intra-transverse process and general spine system (GSS) fixation.

METHODS

From January 2004 to January 2006, 21 patients with multi-segmental lumbar disc herniation and spinal canal stenosis were treated by laminectomy, removal of nucleus pulposus and GSS pedicle screw spinal system. There were 14 males and 7 females with an average age of 53 years ranging from 46 to 61 years, and with an average disease course of 18 months ranging from 8 months to 15 years. All of the patients were examined by X-ray with AP position, lateral position and dynamic lateral position, CT and MRI, and all of them proved to be with multi-segmental lumbar disc herniation and different degrees of spinal canal stenosis. A total of 47 nucleuses were picked out, and 47 instable segments were filled in with granule selfbone.

RESULTS

There were 21 patients who were followed up for 1 to 2 years with an average of 13 months. All patients achieved successful fusion and bony union postoperative from 8 to 12 months, and no artificial joint was formed. As to the clinical results in 21 cases, according to the Macnab outcome criteria, 14 were excellent, 6 were good and 1 was poor, the excellent and good rate was 95.2%.

CONCLUSION

The methods of laminectomy, removal of nucleus pulposus, fusion of intra-transverse process and GSS system fixation are effective in treatment of multi-segmental lumbar disc herniation and spinal canal stenosis.

摘要

目的

探讨采用椎板切除术、髓核摘除术、横突间融合及通用脊柱系统(GSS)内固定治疗多节段腰椎间盘突出症合并椎管狭窄症的疗效。

方法

2004年1月至2006年1月,对21例多节段腰椎间盘突出症合并椎管狭窄症患者行椎板切除术、髓核摘除术及GSS椎弓根螺钉脊柱系统内固定术。其中男14例,女7例;平均年龄53岁(46~61岁),平均病程18个月(8个月~15年)。所有患者均行正侧位及动力位X线、CT及MRI检查,均证实为多节段腰椎间盘突出症合并不同程度的椎管狭窄。共摘除髓核47个,47个不稳定节段均植入自体颗粒骨。

结果

21例患者随访1~2年,平均13个月。所有患者术后8~12个月均获得成功融合及骨性愈合,无假关节形成。21例患者的临床疗效,按Macnab疗效标准评定:优14例,良6例,差1例,优良率为95.2%。

结论

椎板切除术、髓核摘除术、横突间融合及GSS系统内固定治疗多节段腰椎间盘突出症合并椎管狭窄症疗效满意。

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