Hermansen Erland, Moen Gunnar, Fenstad Anne Marie, Birketvedt Rune, Indrekvam Kari
Department of Orthopedic Surgery, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway. ; Kysthospitalet in Hagevik, Orthopedic Clinic, Haukeland University Hospital, Bergen, Norway.
Department of Radiology, Haukeland University Hospital, Bergen, Norway.
Asian Spine J. 2014 Apr;8(2):138-44. doi: 10.4184/asj.2014.8.2.138. Epub 2014 Apr 8.
Retrospective study.
The main purpose of this study was to investigate the union-rate of the spinous process after performing a spinous process osteotomy and whether union affects the clinical results after surgery.
In the present study, spinous process osteotomy was used to facilitate access to the spinal canal when performing a decompressive procedure for lumbar spinal stenosis. The aim of this study was to evaluate the union rate of the spinous process and its effect on the clinical results of the procedure.
All patients were included in the study that underwent a decompressive procedure through spinous process osteotomy be between January 1, 2007 and December 31, 2007. Operation protocols were reviewed. A computed tomography (CT) scan was performed to evaluate the union of the osteotomies of the spinous process. According to the CT-scans, patients were divided into three groups: "complete-union," "partial-union," and "non-union." Patients reported their clinical results through a self-administered questionnaire.
The mean period of follow up was 21.6 months (range, 16-28 months). A total of 44% of the performed osteotomies were considered as united. Ten patients (18%) were classified as "complete-union," 30 patients (55%) as "partial-union," and 15 patients (27%) as "non-union." The "complete-union" group showed better clinical results and scored significantly better in the Oswestry Disability Index and EQ-5D. However, no statistical difference was found in the pain-scores. There were no differences between the "partial-union" group and the "no-union" group.
We found a radiologic union for 60 out of 135 (44%) spinous process osteotomies.
回顾性研究。
本研究的主要目的是调查棘突截骨术后棘突的愈合率以及愈合是否会影响术后的临床结果。
在本研究中，棘突截骨术用于在进行腰椎管狭窄减压手术时便于进入椎管。本研究的目的是评估棘突的愈合率及其对手术临床结果的影响。
纳入2007年1月1日至2007年12月31日期间接受棘突截骨减压手术的所有患者。回顾手术方案。进行计算机断层扫描（CT）以评估棘突截骨处的愈合情况。根据CT扫描结果，将患者分为三组：“完全愈合”、“部分愈合”和“未愈合”。患者通过自行填写问卷报告其临床结果。
平均随访时间为21.6个月（范围16 - 28个月）。总共44%的截骨术被认为已愈合。10名患者（18%）被归类为“完全愈合”，30名患者（55%）为“部分愈合”，15名患者（27%）为“未愈合”。“完全愈合”组显示出更好的临床结果，在Oswestry功能障碍指数和EQ - 5D评分上显著更高。然而，疼痛评分未发现统计学差异。“部分愈合”组和“未愈合”组之间没有差异。
我们发现135例棘突截骨术中60例（44%）有影像学愈合。
