目的　评价脊髓造影CT（CTM）扫描在诊断与治疗多节段退变性腰椎管狭窄症的临床应用价值。  方法　2009年3月-2011年7月， 68例明确诊断后行后路椎间盘镜下有限减压、全椎板或半椎板切除减压术，术前均行CTM明确责任节段。应用VAS、JOA及ODI评分对疗效进行随访评价。  结果　68例患者，CTM明确单侧单节段、双侧单节段责任节段数多于MRI检查（P<0.01)；双侧双节段、单侧3节段及以上、双侧3节段及以上责任节段数少于MRI检查（P<0.01)。至2013年3月，63例获得随访，术后1月和末次随访腰部、下肢VAS与ODI均较术前降低（P <0.01），JOA均升高（P <0.01），末次随访总有效率96.83%。  结论　CTM结合责任节段有限减压是治疗多节段腰椎管狭窄症的有效方法，能达到有效精准减压，使手术的创伤及手术对患者腰椎稳定性的影响降到最低。

Objective　To investigate the clinical efficacy and valuation of myelography CT (CTM) in the surgical treatment of the senile multiple segmental lumbar spinal stenosis.　Methods　From March, 2009 to  July, 2011, there were 68 cases of multi-segmental degenerative lumbar spinal stenosis insenile patients who underwent posterior disc limited endoscopic decompression laminectomy or semi decompressive laminectomy surgery. All patients underwent CTM to confirm affected segments. VAS, JOA and ODI score were used to evaluate the efficacy of postoperative follow-up. 　Results　Unilateral single segments and bilateral single segments in CTM were significantly more than the number of segments liability section in MRI examination (P<0.01). The detection of bilateral double segments, three-segment and above unilateral, bilateral sections of three segments were significantly less than liability section MRI examination (P<0.01). Until March 2013, 63 patients were effectively followed up. Back and lower extremity VAS and ODI in 1 month after the surgery were significantly decreased (P<0.01), JOA was significantly increased (P<0.01). But no significant difference was detected in comparison between last follow-up and 1 month after the surgery. Efficacy was assessed by calculating the rate of JOA improvement in last follow-up, and the total efficiency was 96.83%.　Conclusion　CTM combined with limited liability segmental decompression is an effective way to treat elderly multi-segmental lumbar spinal stenosis, and its efficiency is significant. It can achieve an effective precise decompressionso that the surgeric trauma and impact to spinal stability can be minimized