摘要目的:通过分析棘突间融合撑开固定系统联合有限减压治疗高龄腰椎管狭窄症患者的疗效，探讨其临床应用效果。方法:回顾性分析首都医科大学附属北京友谊医院骨科2016年1月—2020年1月采用棘突间融合撑开固定系统联合有限减压治疗且符合纳入标准的32例高龄腰椎管狭窄症患者资料，其中女性22例，男性10例，患者年龄80~87岁，平均年龄(82.0±2.0)岁。门诊复查随访24个月。在术前、术后、术后6个月及24个月随访进行临床效果评估及影像学测量。采用SPSS 20.0软件进行统计分析。呈正态分布的计量资料以均数±标准差( ± s)表示，组间比较采用单因素ANONA方差分析检验；术前、术后以及术前、随访比较采用配对 t检验。 结果:32例患者均伴随一种或多种常见老年疾病，如高血压、糖尿病、冠心病等。所有患者均顺利完成手术，共32个节段。视觉模拟评分评分由术前(6.22±0.91)分降至24个月随访的(1.94±0.76)分( t＝16.52， P<0.001)、Oswerstry功能障碍指数评分由术前(54.17±10.65)分减至24个月(19.91±4.20)分( t＝15.89， P<0.001)，日本骨科协会评分评分则从(11.69±3.36)分增至(23.44±1.66)分( t＝-19.90， P<0.001)；影像学改变，终板角度由术前的(9.12±4.65)°减至24个月随访的(6.77±2.70)°( t＝3.53， P＝0.001)；椎间盘后缘高度由(0.68±0.19) cm增至24个月随访(0.76±0.19) cm( t＝-2.45， P＝0.020)，差异均有统计学意义。 结论:棘突间融合撑开固定系统联合有限减压可以缓解高龄腰椎管狭窄患者的临床症状，改善生活质量，棘突间融合系统是一种适用于高龄腰椎管狭窄症患者的新型微创内固定器。

abstractsObjective:To analyze the effect of inter-spinal distraction fusion and fixation (ISDFF) combined with limited decompression on the treatment of lumbar spinal stenosis in elderly patients.Methods:A total of 32 elderly patients with lumbar spinal stenosis, aged from 80 to 87 years old (mean age: 82.0±2.0 years) including 10 males and 22 females, in the Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University from January 2016 to January 2020 were enrolled in this retrospective study. Clinical evaluation and imaging measurement were performed before operation, after operation, 6 months and 24 months after operation. SPSS software was used for statistical analysis. Measured data of normal distribution were expressed as means±standard deviation. One way analysis of variance was used for comparison between groups. Paired t-test was used to compare between preoperative and postoperative as well as between preoperative and 24 months′ follow-up. Results:All of the 32 patients had one or more common accompanying diseases, such as hypertension, diabetes, coronary heart disease, and so on. All patients were successfully completed the operation with a total of 32 segments. VAS score was decreased from (6.22±0.91) before operation to (1.94±0.76) at 24 months( t=16.52, P<0.001). ODI score was also demonstrated the similar trend, from (54.17±10.65) preoperatively to (19.91±4.20) at 24 months follow-up( t=15.89, P<0.001). JOA score was significantly increased from (11.69±3.36) before surgery to (23.44±1.66) at the last follow-up ( t=-19.90, P<0.001). In the change of imaging, the intervertebral angle was decreased from preoperation (9.12±4.65) to (6.77±2.70) at 24 months( t=3.53, P=0.001). The posterior disk height was increased from (0.68±0.19) cm to (0.76±0.19) cm at the last follow-up( t=-2.45, P=0.020). Conclusions:As a new type of minimally invasive internal fixator, the ISDFF combined with limited decompression can relieve the pain of elderly patients with lumbar spinal stenosis and improve the quality of life. It is suitable for the treatment of elderly patients with lumbar spinal stenosis.