The Operation Strategy Of Multi-Segmental Lumbar Spinal Stenosis In Elder

Objective To analyse the correlative factors and the treatment strategies of multi-segmental lumbar spinal stenosis in elder.Methods To collect 40 patients whose aged above 60 as subjects that in hosptial during apr 2005 to oct 2008, the 40 patients were diagnosed multi-segmental lumbar spinal stenosis. the 40 cases were retrospected,to collect messages as (1) general: gender,age,preoperative complications,sick time,the narrow segmental lumbar,the unstable segmental lumbar,the segmental of herniated lumbar discs (2) clinical signs and symptoms:the intermittent limb,the feeling and movement of both lower limbs,the feeling of saddle area,the lasegue sympton (3) image data:X-ray,CT,MRI (4) the indicators:the way of laminectomy,laminectomy range,the segmental of fixation,the segmental of fusion,the way of fusion,operation time,amount of bleeding. carries on the data summary and statistics analysis.Results About 85.0% patients have complications before the surgery.the complications would affect the surgery and postsurgical rehabilitation. it is very important to treat preoperative complications actively that may make the patient to accepte the surgery safely;all patients were accepted opration;on the factors of patients'condition,age,the level of comprehensive health to consider to select the way of operation,80.0% patients were accepted internal fixation and fusion, among which fixed three segment and pair of interbody fusion about 17.5 %.two-segment and single interbody fusion is 37.5%.four segment and double interbody fusion is 22.5%.three segment and single interbody fusion about 2.5%.posterolateral fusion with single segment is 37.5%.pair of segment is 32.5%.three segment is 10.0%. when the segment of intraoperative decompression and internal fixation implant were more that lead to operative time and blood loss more.Conclusion For multi-segmental lumbar spinal stenosis in elder that ought to be treated preoperative complications to reduce the effect for operations and choose the best surgical type could be reduce operative time,blood loss and avoid excessive destruction of the bone structure which cause lumbar unstable.so choose the best surgical type that conducive to rehabilitation of elderly patients and avoid postoperative complications. it has important clinical significance for improving patient's quality of life and self-care ability.