Orthopedic treatment of degenerative lumbar spinal stenosis：implant fixation and bony fusion / 中国组织工程研究

ABSTRACT

BACKGROUND:There were no uniform standards or conclusion in the diagnosis of lumbar spinal stenosis, choice of therapeutic manner, location of affected segment, range of decompression, choice of fixation and fusion, indication of surgical treatment and the judgment of posttreatment effects. OBJECTIVE:To search abundant literatures on the advantage and disadvantages of surgical therapies and the range of decompression therapy is of great value on reducing the injury to spine structure and keeping spine stability. METHODS: The first author retrieved PubMed, China National Knowledge Infrastructure and Wanfang Database by computer for related articles published from January 1990 to January 2014. Literatures were about treatment progress of lumbar spinal stenosis, non-surgery therapy and various surgical manners (Laminectomy, fusion, fusion and fixation, non-fusion fixation and minimaly invasive decompression) in treatment of lumbar spinal stenosis. A total of 42 literatures were included. RESULTS AND CONCLUSION:Patients’ age, type and degree of stenosis and morphology of intervertebral disc and vertebral canal were comprehensively evaluated. The indication of surgical treatment was strictly analyzed. The correlation of decompression and stability was handled during surgical therapy. On the basis of thorough decompression, spinal column was kept maximaly. In accordance with patients’ clinical symptoms, signs and imaging characteristics, the range of decompression, fusion and (or) fixation were considered to avoid blindness decompression and non-symptomatic area decompression. Only careful choice could elevate the clinical therapeutic efficacy of lumbar spinal stenosis, make surgical therapy target, save time, and reduce trauma.