| Popis: |
To investigate the technique and effectiveness of modified laminoplasty for lumbar spinal stenosis (LSS) and to explore the application value of modified laminoplasty in maintaining the stability of the spine by comparing with the conventional laminectomy.Fifty-six patients with LSS were included between June 2012 and July 2013, and they were divided into 2 groups: 27 patients underwent modified laminoplasty in group A, and 29 patients received conventional laminectomy in group B. There was no significant difference in sex, age, disease duration, narrow segment, visual analogue scale (VAS) score of low back pain and leg pain, Japanese Orthopaedic Association (JOA) score, and walking tolerance between 2 groups (Dural tear occurred in 2?cases of group A and 1 case of group B and were repaired during operation. All incisions primarily healed without infection. The patients were followed up 24-31 months (mean, 24.7 months) in group A, and 24-37 months (mean, 26.2 months) in group B. The bone healing time was 6-12 months (mean, 9 months) in group A. CT showed healing at the junction of spinous process and vertebral plate in group A at 12 months after operation; new scar in varying degre es was observed in group B. At last follow-up, lumbar spondylolisthesis and instability occurred in 4?and 2 cases of group B respectively, and received re-operation. The change value of slip distance was (0.27±0.23) mm in group A and was (0.83±1.22) mm in group B, showing significant difference (The modified laminoplasty?is better than the conventional laminectomy in relieving low back pain and maintaining the stability of the lumbar spine.通过与传统全椎板切除减压术比较，总结保留腰椎后柱结构的改良椎管成形术治疗腰椎管狭窄症的疗效，初步探索其在保持脊柱稳定性方面的应用价值。.对比研究2012年6月－2013年7月手术治疗的56例腰椎管狭窄症患者临床资料。其中27例行保留腰椎后柱结构的改良椎管成形术（A组），29例行传统全椎板切除减压术（B组）。两组患者性别、年龄、病程、狭窄节段及术前日本骨科协会（JOA）评分、腰痛和下肢痛疼痛视觉模拟评分（VAS）、行走耐受性等一般资料比较，差异均无统计学意义（A、B组各有2例和1例发生术中硬膜囊撕裂，均于术中给予修复；术后切口均Ⅰ期愈合，无感染发生。两组患者均获随访，A组随访时间24～31个月，平均24.7个月；B组24～37个月，平均26.2个月。A组骨愈合时间6～12个月，平均9个月。术后12个月CT示A组患者棘突椎板连接处均已愈合，B组可见新形成的瘢痕。末次随访时，A组无腰椎不稳发生；B组出现腰椎滑脱4例，腰椎不稳2例，均行二次手术治疗。A、B组椎体滑移距离改变值分别为（0.27±0.23）mm和（0.83±1.22） mm，差异有统计学意义（改良椎管成形术治疗腰椎管狭窄症在缓解下腰痛、维持腰椎稳定性等方面明显优于全椎板切除减压术。. |
