本文選題：腰椎管狹窄 + 有限椎板切除��； 參考：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的 比較有限椎板切除減壓術(shù)和全椎板切除減壓術(shù)在治療退行性腰椎管狹窄癥的近期療效。方法 回顧性分析2011年11月至2014年1月收治的退行性腰椎管狹窄癥60例,按手術(shù)方式分為有限椎板切除減壓術(shù)組(A組)和全椎板切除減壓術(shù)組(B組)。分別記錄兩組的手術(shù)時(shí)間、術(shù)中出血量和住院時(shí)間;術(shù)后隨訪采用日本矯形外科學(xué)會(huì)(Japanese orthopaedic association,JOA)評分系統(tǒng)評估兩組術(shù)后神經(jīng)功能恢復(fù)情況;通過術(shù)前術(shù)后影像學(xué)資料測量融合節(jié)段高度和腰椎前凸角度的變化,同時(shí)評估植骨融合程度。結(jié)果 兩組的手術(shù)時(shí)間與住院天數(shù)均無明顯差異,但B組的術(shù)中出血量明顯大于A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后60例患者均獲得隨訪,平均隨訪時(shí)間為22.1個(gè)月(13~35個(gè)月)。兩組術(shù)后JOA評分均較術(shù)前明顯增加,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但組間的JOA評分改善率無明顯差異。兩組術(shù)后融合節(jié)段的高度較術(shù)前明顯增加(P0.05),但術(shù)后6個(gè)月和術(shù)后12個(gè)月B組融合節(jié)段高度丟失較A組更為明顯。術(shù)后兩組腰椎前凸角度(cobb角)與術(shù)前無明顯差異。結(jié)論 有限椎板切除減壓術(shù)和全椎板切除術(shù)兩種手術(shù)方式在治療退行性腰椎管狹窄癥的早期均可獲得滿意的臨床效果,但有限椎板切除減壓術(shù)對脊柱的破壞較少,是一種安全有效治療DLSS的手術(shù)方式。
[Abstract]:Objective to compare the short-term efficacy of limited laminectomy and total laminectomy in the treatment of degenerative lumbar spinal stenosis.Methods from November 2011 to January 2014, 60 cases of degenerative lumbar spinal stenosis were retrospectively analyzed and divided into two groups: group A (treated with limited laminectomy and decompression) and group B (treated with total laminectomy and decompression).The time of operation, the amount of blood lost during operation and the time of hospitalization were recorded, and the postoperative neurological recovery was evaluated by Japanese orthopaedic association (JOAA) scoring system.The height of fusion segment and the angle of lumbar kyphosis were measured before and after operation, and the degree of bone graft fusion was evaluated.Results there was no significant difference in operation time and hospital stay between the two groups, but the amount of intraoperative bleeding in group B was significantly larger than that in group A (P 0.05).All the 60 patients were followed up, the average follow-up time was 22.1 months (13 ~ 35 months).The JOA scores of the two groups were significantly higher than those of the preoperative ones, and the difference was statistically significant (P 0.05), but there was no significant difference in the improvement rate of the JOA scores between the two groups.The height of fusion segment in both groups was significantly higher than that before operation, but the loss of fusion level in group B was more obvious than that in group A at 6 months and 12 months after operation.There was no significant difference in lumbar kyphosis angle between the two groups.Conclusion both limited laminectomy and total laminectomy can obtain satisfactory clinical results in the early stage of treatment of degenerative lumbar spinal stenosis, but limited laminectomy and decompression have less damage to spinal column.It is a safe and effective surgical treatment for DLSS.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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