老年腰椎间盘突出症的特点及外科手术治疗
【摘要】 目的 探讨老年腰椎间盘突出症的特点及外科手术方式与治疗效果。方法 对108例老年腰椎间盘突出症患者行腰椎后路手术治疗,单侧椎板扩大开窗70例,单侧半椎板切除20例,全椎板切除18例。结果 平均随访18个月,按JOA下腰痛评分系统,JOA评分术后平均改善率为75.8%。手术前后JOA评分差异有统计学意义。结论 老年腰椎间盘突出症患者临床表现有其特殊性,手术治疗疗效取决于手术适应证和治疗方案的选择;手术方式因人而易,手术应遵循的基本原则是彻底减压与稳定;手术效果满意。
【关键词】老年人;腰椎间盘突出症;外科手术
The characteristics and surgical treatment of lumbar intervertebral disc herniations in the elderly
【Abstract】 Objective To study the characteristics,the operative project and the effect of lumbar intervertebral disc herniations in the elderly.Methods 108 cases of lumbar intervertebral disc herniations in the elderly underwent lumbar posterior approach,of these 70 cases with windowing-incisions,20 cases with semi-laminectomy and 18 cases with omni-laminectomy were documented.Results 108 cases were followed up and the average period was 18 months.The recovery rate of JOA score was 75.8%.Compared to pre-operation,there was a significant increase of JOA score postoperationly.Conclusion The clinical situation of lumbar intervertebral disc herniations in the elderly has special characteristics and the effect of treatment lie on the operative project.The operative technique is different according to clinical situation.The decompression and stabilization are fundamental.Surgery can ensure the satisfactory outcome.
【Key words】Elderly; Lumbar intervertebral disc herniations; Surgical treatment
作者单位:362800福建医科大学附属第一医院骨科
腰椎间盘突出症好发于青壮年,随着年龄增高,髓核脱水老化,失去其胶冻样特性,髓核突破纤维环的机会减少,故老年腰椎间盘突出症的发病率大为降低,其临床及病理特点、手术方式、围手术期的处理均有别于青...
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