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[老年退行性腰椎管狭窄症的外科治疗]

[Surgical treatment of the old with degenerative lumbar spinal stenosis].

作者信息

Xu Wei-Xing, Lu Di, Wang Jian, Wu Zhen, Zhu Wei-Min, Zhang Chun, Lu Zi-Rong

机构信息

Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2010 Apr;23(4):261-3.

PMID:20486375
Abstract

OBJECTIVE

To investigate the perioperative characteristics and surgical methods in treating the old with degenerative lumbar spinal stenosis.

METHODS

From January 2000 to October 2007, 36 patients with degenerative lumbar spinal stenosis with the age more than 60 years,including 16 males and 20 females, the age from 60 to 81 years with an average of 67.5 years. Of all patients, 6 cases were treated by simple surgical decompression, 16 cases by decompressive laminectomy, 20 cases by decompressive laminectomy combined with internal fixation and fusion.

RESULTS

No death cases occurred during perioperation and complication occurred in 14 cases, including cerebrospinal fluid leakage in 3 cases, incision late healed in 1 case, heart abnormal symptom in 1 case, respiratory infection in 1 case, gastrointestinal symptom in 4 cases, urinary system infection in 1 case, spirital symptom in 1 case. After symptomatic treatment, all complications improved. All the cases were followed up from 6 months to 5 years with an average of 2.5 years. Oswestry scoring improved from preoperative 45.66 +/- 7.12 to postoperative 16.80 +/- 5.75, there was significant difference between before and after operation (P < 0.05).

CONCLUSION

The age and heath condition are not operative absolute contraindication in treating old with degenerative lumbar spinal stenosis,with the proper operation modus after controlling concomitant diseases, the surgical treatment could guarantee the satisfactory therapeutic effect.

摘要

目的

探讨老年退行性腰椎管狭窄症的围手术期特点及手术方法。

方法

2000年1月至2007年10月,36例年龄大于60岁的退行性腰椎管狭窄症患者,其中男性16例,女性20例,年龄60~81岁,平均67.5岁。所有患者中,6例行单纯手术减压,16例行椎板切除减压术,20例行椎板切除减压联合内固定融合术。

结果

围手术期无死亡病例,14例发生并发症,其中脑脊液漏3例,切口愈合延迟1例,心脏异常症状1例,呼吸道感染1例,胃肠道症状4例,泌尿系统感染1例,精神症状1例。经对症治疗后,所有并发症均好转。所有病例随访6个月至5年,平均2.5年。Oswestry评分由术前45.66±7.12提高至术后16.80±5.75,手术前后差异有统计学意义(P<0.05)。

结论

年龄和健康状况并非老年退行性腰椎管狭窄症手术的绝对禁忌证,控制并存疾病后选择合适的手术方式,手术治疗可保证满意的治疗效果。

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