张雅宾;毛克亚;李鹏;王博;张权;顾挺帅;熊森;韩振川;

• 1:中国人民解放军总医院骨科

摘要(Abstract)：

[目的]探讨采用精准椎板减压(精准组)与全椎板切除减压(全切组)手术治疗腰椎管狭窄症疗效的对比研究。[方法]回顾分析了本院2011年1月~2013年1月收治的77例腰椎管狭窄患者的病例资料,其中精准组35例,全切组42例。分别统计其围手术期情况、视觉模拟评分(VAS)、功能障碍指数(Oswestry Disability Index,ODI)、椎旁肌MRI信号改变。[结果]精准组、全切组出血量分别为(189±91)ml/节段、(245±135)ml/节段(P<0.05);引流量分别为(215±106)ml/节段、(300±144)ml/节段(P<0.05);术后住院时间分别为(4.5±1.6)d,(6.1±2.3)d(P<0.05);术后1年腰、腿痛VAS评分与ODI均比同组术前有明显改善(P<0.05),对两组术后腰痛VAS评分(1.6±1.0、2.3±0.9)进行比较,差异有统计学意义(P<0.05);对两组术后腿痛VAS评分(1.2±0.9、1.1±0.9)进行比较,差异无统计学意义(P>0.05);对两组术后ODI指数[(18.0±5.6)%、(21.2±6.8%)]进行比较,差异有统计学意义(P<0.05);对术后1年多裂肌MRI信号比较,差异有统计学意义(P<0.05)。[结论]精准椎板减压能够获得充分的减压疗效,同时保留了脊柱后柱结构的完整,维持术后椎间的稳定性。具有出血少、住院时间短、椎旁肌损伤小等特点。

关键词(KeyWords)： 椎管狭窄;椎板切除;精准减压;椎旁肌

Abstract:

Keywords:

基金项目(Foundation): 军队十二五课题(CWS11J110)微创治疗战创伤脊柱骨折

作者(Author): 张雅宾;毛克亚;李鹏;王博;张权;顾挺帅;熊森;韩振川;

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DOI:

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