颈椎和腰椎并发椎管狭窄症Ⅰ期手术减压的临床疗效

doi:10.13418/j.issn.1001-165x.2015.04.021

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (4): 468-471.doi: 10.13418/j.issn.1001-165x.2015.04.021

颈椎和腰椎并发椎管狭窄症Ⅰ期手术减压的临床疗效

申连成¹，龙厚清²，　徐晶辉²，　黄阳亮²，　李佛保²

1.广东顺德新容奇医院骨科, 广东顺德　528000; 2.中山大学附属第一医院脊柱外科，广州　510080

收稿日期:2015-03-22 出版日期:2015-07-25 发布日期:2015-08-14
通讯作者: 龙厚清，主任医师，E-mail: houqinglong@163.com
作者简介:申连成（1960-）,男，河南人，副主任医师，研究方向：骨科与临床， Tel:13322835068

The anatomic feature and Clinical outcomes of one-staged decompression for patients with combined cervical and lumbar stenosis

SHEN Lian-cheng¹, LONG Hou-qing², XU Jing-hui², HUANG Yang-liang², LI Fo-bao²

1. Department of Orthopedics, Shun De new Rong-qi hospital of Guangdong Province, Guangdong 528303,China; 2. Department of Spine Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510700, China

Received:2015-03-22 Online:2015-07-25 Published:2015-08-14

摘要/Abstract

摘要：

目的　观察Ⅰ期手术减压治疗颈腰椎并发的椎管狭窄症的疗效及其安全性。方法　回顾22例Ⅰ期手术减压治疗颈、腰椎并发的椎管狭窄症的临床资料及围手术期并发症，平均年龄(68.7±9.3)岁(55～83岁)，随访24～58个月，记录手术时间、出血量、住院时间；术前、术后1月和随访末期JOA评分（颈椎17分法、腰椎29分法）及其改善率；患者满意度；并分析围手术期并发症。结果　平均手术时间、失血量、住院时间分别是（189±49）min、（490±70）ml、15.9 d；随访末期JOA改善率分别达到67.9%（C-JOA）、63.5%（L-JOA）,较术前显著改善（P <0.05），病人满意度73.9％；围手术期并发症发生率18.1%，包括急性失血、脑脊液漏、深部感染、短暂性神经损害各1例。结论　Ⅰ 期手术减压治疗颈腰椎并发的椎管狭窄症疗效满意；围手术期并发症并未因此增加，但应严格手术指征。

关键词: Ⅰ期减压, 颈椎, 腰椎, 并发椎管狭窄症

Abstract:

Objective　To evaluate clinical outcomes and safety of one-staged combined cervical and lumbar decompression for patients with tandem spinal stenosis. 　Methods　Clinical outcomes and perioperative complications were reviewed in 22 patients who underwent one-staged combined cervical and lumbar decompression retrospectively. The mean age was (68.7±9.3) years(55～83 years).The follow-up period ranged from 24 to 58 months. The JOA score and its recovery rate（cervical-17 points, lumbar-29 points）were recorded before operation, 1 month after surgery, and at the final follow-up.　Results　The mean surgical duration, blood loss, and hospitalization length were (189±49) min、(490±70) ml、15.9 days respectively. The JOA recovery rate were 67.9% for cervical and 63.5% for lumbar at the final follow-up. The improvement degree of JOA scores was significant compared with that of pre-operation. The overall complication incidence were 18.1%, which included acute blood loss anemia 1 case, cerebrospinal fluid leakage 1 case, deep infection 1 case, Transient neurological deficiency 1 case.　Conclusions　One-staged combined cervical and lumbar decompression for TSS can deliver fair results. It is a safe and effective method for this condition.

Key words: One-stage decompression, CervicalLumbarTandem spinal stenosis

申连成,龙厚清,徐晶辉,黄阳亮,李佛保. 颈椎和腰椎并发椎管狭窄症Ⅰ期手术减压的临床疗效[J]. 中国临床解剖学杂志, 2015, 33(4): 468-471.

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颈椎和腰椎并发椎管狭窄症Ⅰ期手术减压的临床疗效

The anatomic feature and Clinical outcomes of one-staged decompression for patients with combined cervical and lumbar stenosis

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