Selective decompression of lumbar root canal and pedicle screw fixation after laminectomy for the treatment of elderly lumbar spinal stenosis:indications and prognosis
10.3969/j.issn.2095-4344.2016.35.004
- VernacularTitle:选择性神经根管减压和全椎板切除后椎弓根钉内固定修复老年腰椎管狭窄症：适应证及预后
- Author:
Li ZHOU
;
Honglin YANG
;
Xiaojian CAO
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2016;20(35):5195-5202
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Due to complicated and special lumbar spinal stenosis disease and different degrees of lumbar degeneration in the elderly, it requires very careful choice of repair methods and repair technology.
OBJECTIVE:To investigate the indications and prognosis effect of the treatments of elderly lumbar spinal stenosis by selective decompression of lumbar root canal under direct vision and laminectomy.
METHODS:Clinical data of 167 elderly patients with lumbar spinal stenosis were retrospectively analyzed. A total of 82 patients were treated with selective decompression of lumbar root canal as the selective decompression group, with a clear nerve root compression but without central canal stenosis. A total of 85 patients were treated with laminectom and treated with pedicle screw fixation as the whole lamina cut group, with distinct central canal stenosis. The indications were analyzed between the two groups. Clinical effects were assessed using Japanese Orthopaedic Association and Oswestry Disability Index before and after surgery.
RESULTS AND CONCLUSION:(1) Al patients were operated successful y. There was no serious
complication during treatment. (2) Japanese Orthopaedic Association and Oswestry Disability Index were significantly improved at last fol ow-up in two groups compared with preoperation (P<0.05). No significant difference in Japanese Orthopaedic Association and Oswestry Disability Index was detected between the two groups at various time points (P>0.05). Clinical symptoms disappeared or relieved at last fol ow-up in two groups. The prognosis in two groups had significantly improved. (3) Results indicated that laminectomy and pedicle screw fixation in elderly patients with lumbar spinal stenosis and central canal stenosis obtained significant effects. For elderly patients with lumbar spinal stenosis but without central canal stenosis, selective decompression of lumbar root canal under direct vision was given, and it is effective and reliable. The two methods are suitable for different patients, and are effective and reliable way to repair.
