有限手术治疗轻中度成人腰椎侧凸伴发其它退变的疗效分析  

The Treatment Efficiency of Limited Operation on Adult Lumbar Scoliosis combined with Other Degenerative Changes

作　　者：王羽丰[1] 陈博来[1] 林定坤[1] 

机构地区：[1]广东省中医院脊柱专科,广州510120

出　　处：《中国中医骨伤科杂志》2012年第9期22-24,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:评价有限手术治疗成人腰椎侧凸合并椎间盘突出、椎管狭窄和滑脱等退变患者的临床疗效。方法:对18例成人腰椎侧凸合并各种退变保守治疗无效的病人采用有限手术(包括短节段固定融合和单纯开窗减压椎间盘摘除术)治疗,采用Nakai分级标准、VAS和JOA评分评价其疗效,分别于出院和随访时评价。结果:18例患者术前侧凸Cobb角21.6°,手术治疗有效率达100%,VAS评分治疗前6.78分,术后2.3分,随访时1.86分,JOA治疗前13.22分,治疗后22.56分,随访时21.4分,术后侧凸Cobb角无明显改变,平均随访25.9个月,随访有效率达到94.44%;内固定未见松动,侧凸角未见明显增加。结论:30°以内、轻度矢状面异常的成人腰椎侧弯患者,如果产生临床症状的节段较局限,可采用有限手术的方式治疗产生症状的节段,而不需对侧凸进行矫正。Objective： To analyze the treatment efficacy of limited operation for adult lumbar scoliosis combined with degenerative changes such as lumbar disc herniation, spinal stenosis, lumbar spondylolisthesis, and so on. Methods： Eighteen patients with adult lumbar scoliosis combined with the above degenerative changes were treated by limited operation, inclu ding short segmental fixation and fusion or disc discectomy. The Nakai standard and Visual analogue pain score （VAS）, Japanese orthopaedic association （JOA） scoring were used to evaluate the treatment efficiency. Results： All the cases were followed--up for the average time of 25.9 months. The effective rate was 100%, the average VAS was 6.78 pre--surgery, 2.3 post--surgery, and 1.86 during the follow-up; the mean JOA scoring was 13.22 pre-surgery, 22.56 post-surgery, and 21.4 during the follow-up; the mean Cobb＇s angle was 21.6 degree pre-surgery, no change post-surgery and during the follow-up. The effective rate was 94.44% at the last follow-up. Conclusion： For the adult scoliosis with Cobb＇s angle（30 de gree and lightly sagittal abnormity, if the segment causing the symptom was simple, a limited surgery could be used to treated the segment and no need to correct the scoliosis.

关 键 词：腰椎侧凸 退变 有限手术 治疗 

分 类 号：R681.53[医药卫生—骨科学]