后路椎管减压融合内固定术治疗退变性腰椎侧凸疗效与评价  

Posterior decompression,instrumentation and fusion for degenerative lumbar scoliosis:measurement and clinical results

作　　者：曹洪海[1] 张永刚[1] 王征[1] 张雪松[1] 崔赓[1] 王岩[1] 

机构地区：[1]解放军总医院骨科,北京复兴路28号100853

出　　处：《中国矫形外科杂志》2012年第9期803-805,共3页Orthopedic Journal of China

摘　　要：[目的]用VAS、JOA和SRS-22评分评价退变性腰椎侧凸后路椎管减压融合内固定术的临床疗效。[方法]回顾分析2002年7月～2007年1月后路椎管减压内固定术治疗的32例Cobb角均<25°的退变性腰椎侧凸患者。术前术后和随访时均行VAS、JOA评分描述患者症状并分析患者影像学检查结果。术后随访时对患者行SRS-22国际标准量表评分主观评价患者情况,采用SPSS 10.0统计分析软件对数据进行统计分析。[结果]全部32例患者术前Cobb角和腰椎前凸角在术后均得到了一定程度的改善;术前与术后JOA和VAS评分指标均存在显著性差异;SRS-22评分结果尚可接受。[结论]在充分减压的前提下,后路椎管减压融合内固定术对轻度退变性腰椎侧凸可达到满意的临床疗效。VAS、JOA和SRS-22评分作为脊柱外科普遍采用的痛觉评分标准,用于评价退变性腰椎侧凸患者的主观症状,可操作性强,易于被患者接受,有一定的可行性和实用性。[ Objective ] To observe the clinical results of posterior decompression, instrumentation and fusion for degenerative lumbar scoliosis by VAS, JOA and SRS 22 score system. [ Methods ] Thirty - two patients of degenerative lumbar scoliosis were retrospectively studied who received posterior decompression, instrumentation and fusion and follow up from 15 months to 59 months （ average, 31.7 months） . The patients underwent the JOA and VAS score before and after the operation and plus SRS 22 score during the follow up. SPSS 10. 0 was used to summarize and analyze the data, and estimate the clinical results. [ Results] All 32 patients had no surgical infection. All the patients＇ condition had been improved. There was significantly statistical difference between preoperative and postoperative VAS and JOA scale. The results of SRS 22 score showed that the satisfaction, self-imaging and appearance of the patients were not bad. [ Conclusion] The posterior decompression, and fusion for degenerative lumbar scoliosis has good clinical results under sufficient decompression. It＇ s benefit to improve lumbar sagital deformity of the patients and decrease the risk of severe complications. The feasibility and utility of using VAS, JOA and SRS 22 score is indeed to estimate symptoms and postoperative condition of the patients suffering from degenerative lumbar scoliosis.

关 键 词：退变性脊柱侧凸 腰椎 后路 脊柱融合 内固定 全椎弓根螺钉 

分 类 号：R687.3[医药卫生—骨科学]