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老年腰椎管狭窄症与椎间盘移位

[Stenosis of the lumbar canal and intervertebral disk displacement in the aged].

作者信息

Stewen F, Schlegel K F

出版信息

Z Gerontol. 1987 Mar-Apr;20(2):78-83.

PMID:3604382
Abstract

The acquired narrow lumbar canal with compression of epidural cavity and nerve root canals is caused by degenerative bony changes and disc herniation. Clinical and radiological findings are described, especially those in myelography and computerized tomography. Complaints, resistant to conservative treatment, with neurological deficits accompanied by sciatica or intermittent claudication requires a surgical intervention even in old patients. The operative procedure includes decompression of myelin and nerve roots by hemilaminectomy or even laminectomy on one or more levels, combined with partial resection of hypertrophic facets of the intervertebral joints and, if necessary, with nucleotomy. Even old patients can successfully be treated by surgical decompression without severe intra- and postoperative complications, if a good perioperative care and an early postoperative mobilisation are guaranteed. The results with regression of the neurological deficits and with good subjective evaluation are demonstrated by the clinical follow-up of 33 patients aged more than 70 years.

摘要

后天性腰椎管狭窄伴硬膜外腔和神经根管受压是由退行性骨质改变和椎间盘突出引起的。文中描述了临床和影像学表现,尤其是脊髓造影和计算机断层扫描的表现。即使是老年患者,对于保守治疗无效、伴有神经功能缺损并伴有坐骨神经痛或间歇性跛行的患者,也需要进行手术干预。手术操作包括通过半椎板切除术甚至一个或多个节段的椎板切除术对脊髓和神经根进行减压,联合部分切除椎间关节的肥大关节突,必要时进行髓核摘除术。如果能保证良好的围手术期护理和早期术后活动,即使是老年患者也能通过手术减压成功治疗,且无严重的术中及术后并发症。对33例70岁以上患者的临床随访显示了神经功能缺损消退和良好主观评价的结果。

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