Department of Orthopaedic Surgery, Kitasato University, School of Medicine, Kitasato1-15-1, Sagamihara, Kanagawa, Japan.
Int Orthop. 2011 Jan;35(1):67-73. doi: 10.1007/s00264-010-0986-8. Epub 2010 Mar 14.
This article presents the clinical and radiological results of the modified spinous process osteotomy decompressive procedure (MSPO), which affords excellent visualisation and provides wide access for Kerrison rongeur use and angulation while minimising destruction of tissues not directly involved in the pathological process. A total of 50 patients with degenerative lumbar spinal stenosis underwent MSPO between 2002 and 2005. The minimum follow-up period was five years. Patient's walking distance ability was 85.4 m (5-180 m) preoperatively and 2,560 m (1500-8000 m) at the last follow-up. Leg pain improved in 100% of the patients and back pain improved in 89% at the last follow-up. The overall results were good to excellent in 90% of the patients, fair in 16% and all patients were satisfied with the outcome at the last follow-up. The osteotomised spinous process eventually united with the retained laminar bridge in all patients within nine months after surgery. Degenerative lumbar spinal stenosis can be adequately decompressed with less violation of the integrity of the posterior elements using MSPO. The described technique of MSPO yielded promising results with few complications. The authors believe MSPO is less technically demanding and appropriate for general orthopaedic surgeons, occasional spine surgeons and chief residents.
这篇文章介绍了改良棘突截骨减压术（MSPO）的临床和影像学结果，该手术提供了极好的可视化效果，并为 Kerrison 咬骨钳的使用和角度提供了广泛的通道，同时最大限度地减少了对与病理过程不直接相关的组织的破坏。2002 年至 2005 年间，共有 50 例退行性腰椎椎管狭窄症患者接受了 MSPO。最小随访期为 5 年。患者术前步行距离能力为 85.4m（5-180m），末次随访时为 2560m（1500-8000m）。100%的患者腿痛改善，89%的患者腰痛改善。末次随访时，90%的患者总体疗效良好，16%的患者疗效良好，所有患者对疗效均满意。所有患者术后 9 个月内，截骨棘突最终与保留的椎板桥愈合。MSPO 可在不破坏后柱完整性的情况下充分减压退行性腰椎椎管狭窄症。描述的 MSPO 技术具有良好的效果，并发症少。作者认为 MSPO 技术要求较低，适合普通骨科医生、偶尔进行脊柱手术的医生和住院总医师。
