[1]潘　林.后路腰椎全椎板减压术术后腰椎失稳对腰椎管狭窄患者远期疗效的影响[J].新乡医学院学报,2017,34(5):439-441.[doi:10.7683/xxyxyxb.2017.05.025]
　PAN Lin.Effect of lumbar instability on long term outcome of patients after posterior decompressive lumbar laminectomy[J].Journal of Xinxiang Medical University,2017,34(5):439-441.[doi:10.7683/xxyxyxb.2017.05.025]
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后路腰椎全椎板减压术术后腰椎失稳对腰椎管狭窄患者远期疗效的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年5
页码:
439-441
栏目:
临床研究
出版日期:
2017-05-05

文章信息/Info

Title:
Effect of lumbar instability on long term outcome of patients after posterior decompressive lumbar laminectomy
作者:
潘　林
（信阳市中心医院骨科，河南　信阳　464000）
Author(s):
PAN Lin
（Department of Orthopaedics，the Central Hospital of Xinyang，Xinyang 464000，Henan Province，China）
关键词:
全椎板减压术; 后路腰椎; 腰椎管狭窄症; 腰椎失稳; 远期疗效
Keywords:
lumbar laminectomy; posterior lumbar; lumbar spinal stenosis; lumbar instability; long term outcome
分类号:
R681.5
DOI:
10.7683/xxyxyxb.2017.05.025
文献标志码:
A
摘要:
目的　探讨后路腰椎全椎板减压术后腰椎失稳情况对患者远期疗效的影响。方法　选择2006年9月至2012年6月在信阳市中心医院行单节段后路全椎板减压术的腰椎管狭窄患者82例，根据患者术后X线片复查腰椎是否发生失稳情况分为失稳组（30例）和无失稳组（52例），患者术后均随访4 a以上，观察2组患者术前、术后3个月及末次随访时疼痛视觉模拟（VAS）评分和术后腰椎改善情况并进行比较。结果　2组患者术后3个月及末次随访时VAS评分和改良日本骨科学会腰痛评分标准（JOA）评分均显著优于术前，末次随访时VAS评分和JOA评分均显著优于术后3个月（P<0.05），但2组患者之间术前、术后3个月及末次随访时VAS评分和JOA评分比较差异均无统计学意义（P>0.05）。失稳组和无失稳组患者术后腰椎评分的平均改善率分别为（74.2±10.7）%和（78.6±11.5）%，获得改善患者分别为24例（80.0%，24/30）和43例（82.7%，43/52），2组患者术后腰椎的平均改善率及获得改善情况比较差异无统计学意义（t=1.037，χ2=0.090；P>0.05）。结论　腰椎管狭窄症患者在采取后路腰椎全椎板减压术后能有效改善其临床症状，并保护了脊柱的运动功能，部分患者发生腰椎失稳情况，但对患者的远期疗效无明显影响。
Abstract:
Objective　To study the effect of lumbar instability on long term outcome of patients after posterior decompressive lumbar laminectomy.Methods　Eighty-two patients with lumbar spinal stenosis who received posterior decompressive lumbar laminectomy in the Central Hospital of Xinyang from September 2006 to June 2012 were selected as subjects.The patients were divided into instability group（with lumbar instability）（n=30） and non-instability group（without lumbar instability）（n=52） according to the result of X-ray examination after operation.All patients were followed up for over four years.The visual analogue scale（VAS）and postoperative lumbar improvement of patients before operation and three months after operation and at the end of the last follow-up were observed and compared between the two groups.Results　The VAS and Japanese orthopaedic association（JOA）scores of patients at three months after operation and the last follow-up was significantly better than that before operation in the two groups（P<0.05）.The VAS and JOA scores of patients at the last follow-up were significantly better than those at three months after operation in the two groups（P<0.05）.There was no significant difference in the VAS and JOA scores of patients between the two groups at the time points of before treatment，three months after operation and the last follow-up（P>0.05）.The average improvement rate of lumbar score of patients in the instability group and non instability group was(74.2±10.7)% and (78.6±11.5)% respectively;the improvement rate of patients in the above two groups was 80.0%(24/30) and 82.7%(43/52) respectively;there was no significant difference in the average improvement rate of lumbar score and improvement rate of patients between the two groups（t=1.037,χ2=0.090；P>0.05）.Conclusion　The posterior decompressive lumbar laminectomy can improve the clinical symptom and protect the motor function of spine in patients with lumbar spinal stenosis.The surgery also can lead to lumbar instability in some patients，however，it has not significant effect on the long-term efficacy of patients.

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更新日期/Last Update: 2017-05-05