可膨胀椎弓根螺钉治疗退行性脊柱侧凸的疗效分析  

Clinical effect of degenerative scoliosis treated with expansive pedicle screws

作　　者：吴兵[1] 张永刚[1] 宋凯[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《解放军医学院学报》2015年第5期458-460,共3页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨可膨胀椎弓根螺钉（expansive pedicle screws,EPS）治疗成人退行性脊柱侧凸畸形（degenerative scoliosis,DS）的临床效果。方法回顾性分析我科2012年1月-2013年9月手术矫形治疗的DS患者21例,其中男性4例,女性17例,平均年龄60.1（45~74）岁。均采用EPS进行矫形固定。术前、术后5~7 d、术后1年拍摄脊柱全长X线片测量影像学参数观察矫形变化。收集术前、术后1年腰腿痛VAS及ODI评分评定生活质量。结果 21例均随访1年以上。术中使用EPS 252根,3次共5根螺钉矫形时拔钉。术后Cobb角、C7至骶骨中线铅垂线偏移距离、腰椎前凸角、骨盆倾斜角、骶骨倾斜角、失状位垂直轴与术前差异有统计学意义（P〈0.05）,矫形效果满意;手术前后腰痛VAS、腿痛VAS及ODI评分分别为6.2±2.2、3.8±1.5,5.3±2.7、3.3±2.3,35.3±6.4、17.6±7.3,差异有统计学意义（P〈0.05）,生活质量明显改善。结论应用可膨胀椎弓根螺钉治疗退行性脊柱侧凸可获得良好的临床疗效。Objective To discuss the clinical effect of adult degenerative scoliosis （DS） treated with expansive pedicle screws （EPS）.Methods Clinical data about 21 cases with DS who underwent orthopaedic operation by EPS in our hospital from January 2012 to September 2013, including 4 males and 17 females with an average age of 60.1 years （range from 45-74 years）, were retrospectively analyzed. The spinal length X-rayfilms were taken at pre-operative, 5-7 d and 1 year after operation, and imaging parameters were recorded. The scores of lumbago and skelalgia of VAS and ODI were collected.Results All cases were followed up for more than 1 year. 252 EPSs were used, and 5 screws were pulled out. The comparison of Cobb angle, C7-CSVL, LL, PT, SS, SVA of pre-operative and pro-operative had statistical significance （P〈0.05）. The lumbago and skelalgia of VAS and ODI scores of pre-operative and pro-operative were （6.2±2.2, 3.8±1.5）, （5.3±2.7, 3.3±2.3）, （35.3±6.4, 17.6±7.3）, respectively, which had statistical significance （P〈0.05）. The orthopaedic effect was excellent.Conclusion Application of expandable pedicle screws in treatment of degenerative scoliosis can obtain good clinical efficacy.

关 键 词：脊柱侧凸 脊柱内固定器 骨螺钉 退行性疾病 

分 类 号：R687.3[医药卫生—骨科学]