孙伟;薛骋;唐先业;赵杰;袁峰;郭开今;

• 1:徐州医科大学附属医院骨科
• 2:上海交通大学医学院附属第九人民医院骨科

摘要(Abstract)：

[目的]比较选择性减压融合与多节段减压融合治疗伴退行性滑脱的多节段腰椎管狭窄症的临床疗效。[方法]将2012年1月~2014年1月收治的36例伴有退行性滑脱的多节段腰椎管狭窄症患者随机分为选择性减压融合组(选择组,19例)和多节段减压融合组(多节段组,17例)。选择组仅对引起临床症状的部位进行减压,对术前存在腰椎滑脱或不稳的节段以及术后可能出现失稳的节段予以固定融合。多节段组对影像学所见的狭窄节段均进行充分减压、固定融合。比较两组的年龄、性别、病程、手术时间、失血量、减压节段和融合节段。用JOA、VAS及ODI评分评估临床疗效。随访拍摄腰椎X线片和MRI,观察腰椎稳定性。[结果]所有患者均获得2年以上随访。多节段组的手术时间、失血量及融合节段均大于选择组(P<0.05)。两组病例术后末次随访的JOA、VAS和ODI评分均较术前改善(P<0.05),末次随访的JOA、VAS和ODI评分两组间差异无统计学意义(P>0.05)。选择组减压未融合节段无医源性失稳表现。[结论]选择性减压融合与多节段减压融合治疗伴退行性滑脱的多节段腰椎管狭窄症疗效相当,选择性减压融合具有手术时间短、失血量少和创伤小等优点。

关键词(KeyWords)： 选择性减压融合;退行性滑脱;多节段腰椎管狭窄

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 孙伟;薛骋;唐先业;赵杰;袁峰;郭开今;

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参考文献(References)：

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