Abstract: 【Abstract】 Objective To compare the clinical effects between simple spinal canal decompression and decompression with fusion in the treatment of simple degenerative lumbar spinal stenosis. Methods From March 2006 to May 2011, 63 cases with degenerative lumbar spinal stenosis undergoing surgical operation were analyzed retrospectively..And the patients were followed up one year after operation. Among them,.28 cases underwent simple lumbar spinal canal decompression and 35 cases underwent spinal canal decompression with fusion..The clinical effects of two surgical procedures were evaluated by JOA (Japanese Orthopedic Association) score, ODI (Oswestry Disability Index) score and SF-36 (Short Form-36) score before and after operation. Results Better results were got in both two groups in one year follow-up period after operation..In the spinal canal decompression plus fusion group, postoperative ODI score was improved in 31.2 scores (P<0.001) and the patients- dysfunction was improved from severe to mild. In the spinal canal decompression group,.the postoperative ODI score was improved in 14.9 scores (P=0.004) and the patients- dysfunction was improved from severe to middle. Decompression plus fusion group was significantly better than that simple decompression group (P<0.01)..Postoperative SF-36 score was similar between two groups. Conclusion Surgery was effective on the patients with lumbar spinal stenosis..Compared with decompression plus fusion and simple decompression, the former-s superior to the latter in the improvement of clinical symptoms.

Key words: Lumbar spine, Decompression, Internal fixation, Fusion, Spinal canal stenosis

摘要： 【摘要】 目的 比较单纯椎管减压术和减压后器械内固定融合治疗无腰椎滑脱和失稳的退变性腰椎管狭窄症的临床疗效。方法 自2006年3月~2011年5月期间,在我院接受手术治疗的单纯退变性腰椎管狭窄症患者共63例,其中接受单纯选择性椎管减压术治疗的患者28例,接受椎管减压加器械内固定融合手术患者35例。手术前后分别使用腰椎JOA (Japanese Orthopedic Association) 评分、ODI(Oswestry Disability Index)评分和SF?鄄36(Short Form?鄄36)评分,评估两种术式的临床疗效。结果 两组患者术后1年均取得较好疗效。其中椎管减压加融合组患者术后ODI评分改善31.2分(P<0.001),由重度功能障碍改善至轻度功能障碍;单纯选择性椎管减压组术后ODI评分改善14.9分(P=0.004),由重度功能障碍改善至中度功能障碍;减压加融合组预后较单纯减压组显著改善(P<0.01),术后SF?鄄36评分得到相似结果。结论 手术治疗能极大地改善腰椎管狭窄患者的临床症状,椎管减压加融合术较单纯椎管减压术能更大程度改善该类患者的临床症状。

关键词: 腰椎, 减压, 内固定, 融合, 椎管狭窄, 回顾性分析