Surgical Treatment Of Complicated Lumbar Spinal Stenosis

Objective :To investigate the surgical indication,the operative type and the operative effect of the complicated lumbar spinal stenosis.Methods :From Jan,1996 to Jan,2008,67 patients acceped surgical treatments in our hospital due to complicated lumbar spinal stenosis. Their ages were from 34 to76,average 59.2.;Their courses of disease were from 4 months to 30 years,average 5 years and 2 months. 56 patients were followed up,among of which 27 patients accepted total laminectomy and 29 patients accepted laminectomy and lumbar fusion and transpedicular screw fixation.Results :1.According to the JOA score standard,the fineness rate was 59.26% in the patients accepted total laminectomy and 89.66% in the patients accepted laminectomy and lumbar fusion and transpedicular screw fixation.2.According to dynamic X-ray, the rate of lumbar segmental instability was 66.67% in the patients accepted total laminectomy and 6.90% in the patients accepted laminectomy and lumbar fusion and transpedicular screw fixation. There were significant differences between the two groups statistically.3.The incidence of complications were 7.41%,14.81% respectively.Conclusion :1.Strictly according to surgical indications ,the different surgical methods for the treatment should be elected for the different types of lumbar spinal stenosis .2.It is a better selection for patients of complicated lumbar spinal stenosis to accept an operation including laminectomy,lumbar fusion and transpedicular screw fixation.3.For patients of lumbar spinal stenosis combined with lumbar segmental instability, it is better to accept the operation of laminectomy and lumbar fusion and transpedicular crew fixation, at the same time ,which is helpful to obtain a more stable lumbar...