Spine Center, Tokyo West Tokushukai Hospital, 3-1-1 Matsubara-cho, Akishima, Tokyo 196-0003, Japan.
Arch Orthop Trauma Surg. 2011 Jun;131(6):753-8. doi: 10.1007/s00402-010-1207-z. Epub 2010 Dec 16.
Retrospective clinical study has done concerning the outcomes of lumbar spinal stenosis (LSS) patients treated with trans-interspinous ligament approach method. The object is to determine the efficacy of this procedure and to confirm that the interspinous ligament could be removed for the decompression surgery.
Seventy patients were treated with this method and 63 patients were followed up for more than 4 years. Operative time, blood loss, complications of surgery and further surgery were checked out. During the follow-up period, JOA score and lumbar spine X-ray were evaluated.
The average operative time was 51 min, average operative time per one level was 32 min, and the average blood loss was 57 ml. The recovery rate was excellent in 26, good in 24, fair in 8 and poor in 5 patients. Four of 63 patients (6.3%) needed further surgery and among them only 2 cases (3.2%) needed reoperation because of the instability of the operative levels.
The trans-interspinous ligament procedure is a simple decompression method completed quickly and accomplishes absolute decompression for LSS. The interspinous ligament should be removed for decompression with a case of lumbar spinal canal stenosis.
本研究回顾性分析了经棘突间韧带入路治疗腰椎管狭窄症(LSS)患者的临床疗效,旨在评估该术式的有效性,明确是否可通过切除棘突间韧带进行减压。
70 例患者采用该方法治疗,63 例获得 4 年以上随访。观察手术时间、出血量、手术并发症及再次手术情况,随访期间采用日本骨科协会(JOA)评分和腰椎 X 线评估疗效。
手术时间平均 51 min,单节段手术时间平均 32 min,术中出血量平均 57 ml。根据改良 MacNab 疗效评价标准,优 26 例,良 24 例,可 8 例,差 5 例。4 例(6.3%)患者需要再次手术,其中仅 2 例(3.2%)因手术节段不稳而再次手术。
经棘突间韧带入路是一种操作简单、手术时间短的减压方法,可快速彻底减压治疗 LSS,对于合并腰椎管狭窄的患者,应切除棘突间韧带进行减压。