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Treatment, the success of their pregnancy, cytokines also showed Cloning Thl to Th2 shift. So depth of '506 * Jiangsu University (Medicine Edition) AcademicJournalofJiangsuUniversity (medicine), October2002, 12 (5) degenerative lumbar spinal stenosis surgery of Dai Chunhong (Taixing People's Hospital of Orthopaedics, Jiangsu Taixing 225400) [key Words】 spinal canal stenosis; lumbar stability of the [CLC】 R681.5 [Document code】 B [Article ID】 1671-7783f2oo2) o5 a o5o6-02 is a degenerative lumbar spinal stenosis in elderly low back pain one of the causes. ... Symptoms and the majority of ineffective conservative treatment or require surgical decompression. Treatment depends on the decompression surgery or not. We are based on pathology and imaging results, the stability of degenerative lumbar spinal stenosis and instability into two categories, respectively, on this basis, different combinations of surgical methods. Since January 1994 ~ December 2000 35 patients, results were satisfactory, are as follows. 1 Data and methods 1.1 General Information The group of 35 cases, 20 males and 15 females; aged 43 to 65 years, mean 51.3 years old. Duration of 6 months to 15 years. Average of 3 years and 2 months. Medium manual workers in 24 cases, 11 patients with mild manual. Have a clear history of trauma in 6 cases. Case selection criteria: ① a lumbar spinal canal stenosis of the clinical manifestations: Horsetail II spondylolisthesis, foraminal deformation or lateral film showed a small, oblique film except for lumbar spondylolysis; ③ CT films showed the central canal of lumbar sagittal diameter ≤ 10Innl, lateral recess ≤ 3Innl. Imaging data of 35 cases of 1.2 lumbar radiographs show different degrees of lumbar degenerative changes, 20 routine CT scan after myelography, the rest for cT inspection. Which L4,, s. And, a narrow two planes were 18 cases and 11 cases each,, L4, and ~ S. 3 plane involved in 6 cases. Lumbar spine x-ray film showed motivation: 6 patients were lumbar spondylolisthesis degree of instability II. CT slice measured: lumbar sagittal diameter of the central canal of the narrowest 6Innl, the most wide-9Innl, the average 7.1mrn; 3 planes lateral recess narrowest 1.5Innl, the most wide-3.8111111. The average 2.6Innl; yellow ligament thickness 3 ~ 7Innl. 1.3 Procedures 1.3.1 window Sneak lateral decompression for spinal stenosis, according to the narrow circumstances for the unilateral or bilateral, single vertebra or vertebrae. Facet of this law to the center, open laminectomy bone with a sharp knife after the 45 degrees oblique resection of the lateral articular process under the 40% to 50% of the medial and the medial facet on the 1 / 3, in particular, removal of the proliferation of yellow ligament, osteophytes, disc probe, if necessary, be removed. Note that the above line and down the nerve root to sneak into the lateral recess decompression until the diameter of 6Innl. 1.3.2 Structure of the reservation, decompression and fusion surgery on the side of the central spinal canal stenosis and stenosis, the use of the rear of the structure to retain the central canal and lateral recess decompression and intertransverse process fusion surgery. After the median sternotomy access, retention supraspinous ligament, interspinous ligament and spinous processes of the integrity of the upper lamina decompression include lower 1 / 3 and the lower lamina of the upper 1 / 4, both sides of the sneak decompression, the full removal of Bone hyperplasia and yellow ligament. Were used for multi-segmental decompression laminectomy jump method can achieve both lift the oppression, to expand the spinal canal and lateral recess, without affecting the lumbar spine stability purposes. 1.3.3 short segment pedicle screw fixation and decompression and fusion for lumbar spinal stenosis law with lumbar spinal instability were. Line canal and lateral recess decompression at the same time, the use of three short segment pedicle fixation with vertebral articular process, transverse process bone graft. 2 Results 35 patients were followed up for minimum of 6 months, up to 2 years and 8 months. Efficacy evaluation: excellent: symptoms and signs disappeared, returned to normal work; good: mild low back pain, return to work and daily life; may: reduce symptoms, life can take care of themselves; poor: no improvement after surgery. This group: excellent in 15 cases, good in 17 cases, 2 cases and poor in 1. 3 Discussion 3.1 surgical indications Department of degenerative lumbar spinal stenosis lumbar intervertebral disc, facet,[link widoczny dla zalogowanych], ligament degeneration, hyperplasia, more common in L4 and ~ s. Segment can be divided into three: loss of function of: the recurrent low back pain as the main performance; unstable period: dominated by low back pain and lower extremity radiating pain; re Stabilization: Patients may have disc herniation, central canal or the side of the vertebral Typical stenosis

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