优先选择颈椎或腰椎手术治疗共存的颈腰椎椎管狭窄症:74例预后分析

发布时间：2018-03-18 14:21

本文选题：脊柱　切入点：共存的颈腰椎椎管狭窄症　出处：《中国矫形外科杂志》2017年11期 　论文类型：期刊论文

【摘要】：[目的]证明优先选择颈椎或腰椎手术对治疗共存的颈腰椎椎管狭窄症患者症状改善更优。[方法]收集本院2000年1月~2014年12月随访时间1年的共存颈腰椎管狭窄症患者74例,通过相关评价指标分别评估分期手术中优先选择颈椎或腰椎对预后的影响。[结果]随访18~156个月(58.00±36.50)个月。优先颈椎手术的腰椎再手术率比优先腰椎手术的颈椎再手术率低(22.91%57.69%)(P0.01)。优先颈椎手术JOA评分及Nurick分级较术前均显著改善(P0.01),ODI评分较术前改善(P0.05)。优先腰椎术后与术前相比,JOA评分及Nurick分级无明显改善(P0.05),ODI评分明显改善(P0.01)。[结论]治疗并存的颈腰椎椎管狭窄症患者,优先颈椎手术是安全有效的,在颈腰椎症状改善、肢体功能恢复及另一部位再次手术率方面优于优先腰椎手术。
[Abstract]:[objective] to prove that the first choice of cervical spine or lumbar surgery is better for the treatment of co-existing cervical and lumbar spinal stenosis. [methods] 74 cases of co-existing cervical and lumbar spinal stenosis who were followed up for one year from January 2000 to December 2014 in our hospital were collected. The influence of cervical vertebrae or lumbar vertebrae on prognosis was evaluated by relevant evaluation indexes. [results] follow up for 18 ~ 156 months (58.00 卤36.50) months. The rate of lumbar reoperation in priority cervical surgery is higher than that in priority lumbar surgery. The JOA score and Nurick grade of priority cervical vertebra surgery were significantly improved compared with those before operation. The JOA score and Nurick grade of priority lumbar vertebrae operation were not significantly improved compared with those before operation. [conclusion] treatment. Patients with cervical and lumbar spinal stenosis, Priority cervical surgery is safe and effective and is superior to priority lumbar surgery in terms of improvement of cervical and lumbar vertebrae symptoms, recovery of limb function and reoperation rate of another site.
【作者单位】：上海市同济大学附属东方医院脊柱外科;
【基金】：国家自然基金资助项目(编号:81371994) 浦东新区卫生系统重点学科建设资助(编号:PWZx2014-02)
【分类号】：R687.3

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