Posterior approach treatment of old traumatic lumbar spinal stenosis / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate the posterior approach treatment of old traumatic lumbar spinal stenosis,lumbar kyphosis,intervertebral space stenosis using vertebral plate decompression,nucleus pulposus removal,intervertebral fusion and CAPSTONE cage insertion and internal fixation with pedicle screw and rod,TLIF.[Method]Twenty patients with low lumbar spinal canal and intervertebral space stenosis,lumbar kyphosis caused by trauma were enrolled in this study.There were 13 males and 7 females,with an average age of 31.4 years (range 22-49).Four had lesions of L3、4,10 of L4、5 and 6 of L5S1.One patient was treated at 4 years after injury,3 within 9-15 months,6 within 3-6 months and 10 within 1-3 months after injury.All patients were treated with vertebral plate decompression,some serious patients underwent laminectomy decompression,nucleus pulposus removal,intervertebral fusion,CAPSTONE cage insertion and internal fixation with pedicle screw and rod,TLIF.One week after surgery,patients could wear thoracic waist-iliac orthosis and take out-of-bed activity.[Result]All the patients lumbodynia,lower limb pain,muscle strength and hypoesthesia improved within one week after operation.X-rays showed that both the intervertebral space and the physiological curvature improved to some degrees.Twenty patients were followed up(ranged,1 to 3 years)and the clinical outcomes were good.The average Franke1 grade was 1.4.Re-X-rays showed that interbody fusion was achieved in all 20 patients.No loss was found about the altitude of the intervertebral space and the physiological curvature.[Conclusion]For patients with old traumatic lumbar spinal stenosis,the recovery of body altitude is almost impossible.This method is simple and has less complications.It can be widely used in the clinical practice.