后路选择性短节段矫形固定治疗退变性腰椎侧凸症疗效分析  

Effect of selective short-segment decompression and fusion in the treatment of degenerative lumbar scoliosis

作　　者：钱宇锋[1] 薛峰[1] 盛晓文[1] 彭育沁[1] 陈兵乾[1] 

机构地区：[1]江苏省苏州大学附属常熟医院脊柱外科,江苏常熟215500

出　　处：《颈腰痛杂志》2013年第4期324-327,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨后路选择性减压短节段融合固定术治疗退变性腰椎侧凸症的中期效果。方法回顾分析2006-06-2010-03我院采用后路选择性减压短节段融合固定术治疗的退变性腰椎侧凸症患者71例,定期随访VAS、JOA评分并测量腰椎Cobb's角和前凸角。结果患者术后症状明显好转,四个指标均明显改善(P<0.05):平均VAS评分由术前6.32降至术后1.86,JOA评分由13.31增加至24.17,冠状位Cobb's角由19.65°矫正至10.32°,矢状位Cobb's角由32.38°增加至42.31°。JOA改善率为32.64%,侧凸矫正率为47.48%。经过平均4.14年的随访发现上述效果出现轻度丢失,末次随访时16例侧凸进展,其中12例症状加重。结论对于侧凸角度不大、脊柱基本平衡的DLS患者,采用后路选择性减压短节段融合固定术可获得良好的效果,并可以显著的减少手术创伤和术后并发症。Objective To explore the medium-term effect of selective short-segment decompression and fusion in treatment of elderly patients with degenerative lumbar scoliosis.Methods Seventy-one elderly patients with degenerative lumbar scoliosis who received selective short-segment decompression and fusion surgery from June 2006 to March 2010 were enrolled in this study.The patients were followed up and the VAS scores,JOA scores and Cobb’s angle from lumbar radiography were observed.Results The symptoms of the patients were significantly improved after operation（P＆lt;0.05）.The average VAS scores decreased from 6.32 to 1.86 after operation,the average lumbar JOA scores increased from 13.31 to 24.17.The average coronal Cobb’s angle decreased from 19.65°to 10.32°,the average lumbar lordosis angle increased from 32.38°to 42.31°.The improvement rate of JOA was 32.64%,and that of scoliosis was 47.48%.After an average of 4.14year follow-up,the effect lost in the four parameters.There were 16 patients progressed in the Cobb’s angle,and 12 patients progressed to aggravated symptoms.Conclusion This technique selectively decompressed the accountable segments and rectified the curve with short-segment fusion could prove great effects with little complications,which is recommended for patients with small Cobb angle and good spinal balance.

关 键 词：退变性腰椎侧凸 选择性 短节段 融合 

分 类 号：R681.55[医药卫生—骨科学]