MULTILEVEL LUMBAR LAMINOTOMIES - AN ALTERNATIVE TO LAMINECTOMY IN THE TREATMENT OF LUMBAR STENOSIS
MULTILEVEL LUMBAR LAMINOTOMIES - AN ALTERNATIVE TO LAMINECTOMY IN THE TREATMENT OF LUMBAR STENOSIS
复制标题
DOI：
10.1227/00006123-199003000-00009
复制
发表时间：
1990-03-01
期刊：
影响因子：
4.8
通讯作者：
DUCKER, T
中科院分区：
文献类型：
--
作者：
ARYANPUR, J;DUCKER, T
腰椎管狭窄症的传统治疗方法是广泛的椎板切除术。该手术成功率高，并发症发生率低，但并非微不足道。然而，最近，对腰椎管狭窄症的病理生理学有了更好的理解，一些作者提出了一种更有限的减压术，专门针对压迫的区域。在过去的5年中，我们已经治疗了32例腰椎管狭窄症患者使用减压椎板切开术。 我们的患者都有局灶性侧隐窝狭窄，通过计算机断层扫描或磁共振成像诊断。我们在适当的节段进行了减压椎板切开术和椎间孔切开术。这种手术比全椎板切除术的破坏性小，并且在有经验的人手中，需要更少的手术时间。在最后一次随访中，90%的接受治疗的患者报告了极好的结局，即症状完全缓解和/或恢复正常的日常活动。无明显的术后发病率或死亡率。我们的结论是，在选定的腰椎管狭窄症患者亚组中，多节段椎板切开术可能是椎板切除术的一种可接受的替代方法。
The traditional treatment for lumbar stenosis is a wide laminectomy. The procedure has a high success rate and a low, but not insignificant, incidence of complications. Recently, however, a better understanding of the pathophysiology of spondylotic lumbar stenosis has led several authors to propose a more limited decompression directed specifically toward the offending area of compression. Over the past 5 years, we have treated 32 patients with lumbar stenosis using decompressive laminotomies. Our patients all had focal lateral recess stenosis that was diagnosed by computed tomography or magnetic resonance imaging. We performed decompressive laminotomies and foraminotomies at appropriate levels. This procedure is less disruptive than a full laminectomy and, in experienced hands, requires less operating time. At last follow-up, 90% of the patients so treated reported an excellent outcome.sbd.namely, total relief of symptoms and/or return to normal daily activities. There was no significant postoperative morbidity or mortality. We conclude that in a selected subgroup of patients with lumbar stenosis, multilevel laminotomies may be an acceptable alternative to laminectomy.